UAB Hospital is listed among “America’s Best Hospitals for Obstetrics” by the 2015 Women’s Choice Award and “100 Hospitals with Great Women’s Health Programs” by Becker’s Hospital Review.

The Women’s Choice Award was given after a review of the services provided and patient satisfaction scores, with additional consideration given to the hospital’s record for clinical care and full-term deliveries. Becker’s Hospital Review features hospitals that offer outstanding health services geared toward women, including gynecology, obstetrics, women-focused heart care and women-focused cancer care.

“These are exceptional honors that recognize the tremendous efforts of the staff and physicians who work around the clock to provide both routine and comprehensive, cutting-edge health care to women,” said William Andrews, Ph.D., M.D., professor and chair of UAB’s Department of Obstetrics and Gynecology. “We strive to serve our patients and their families with professionalism, respect and compassion in an environment designed to maximize their comfort and experience. The entire team in the UAB Women and Infants Center is extremely proud to receive these prestigious awards.”

Women’s Choice Award is a consumer advocacy group that helps women make smart health care decisions. This marks the third year that the group has presented the award to the nation’s leading obstetrics programs. UAB Obstetrics has earned this recognition for each of those three years, in the category for hospitals with 400-plus beds.

The Women and Infants Center is the only hospital in Alabama where maternal-fetal medicine physicians are available in-house 24 hours a day, 365 days a year. The world-class facility is dedicated to the care of women and infants and can provide inpatient surgical care or routine outpatient office visits under one roof in a comfortable, family-friendly atmosphere.

“UAB is a large organization, so for it to maintain this ranking consistently is a great achievement,” said Delia Passi, CEO and founder of Women’s Choice Award. “Our awards are evidence-based and 100 percent objective — it’s not easy to get on our list.”

The Becker’s Hospital Review editorial team selected hospitals for inclusion on its “100 Hospitals” list based on clinical accolades and recognition for women’s health excellence from various health care groups and agencies, including U.S. News & World Report, Healthgrades, CareChex and UNICEF’s Baby-Friendly Hospital Initiative, a designation UAB is on course to attain in 2015.

UAB boasts one of the largest maternal-fetal medicine programs in the country, and it is one of only 14 centers nationwide — and the only center in Alabama — in the Maternal-Fetal Medicine Units Network.

The Women and Infants Center is the only hospital in Alabama where maternal-fetal medicine physicians are available in-house 24 hours a day, 365 days a year. The world-class facility is dedicated to the care of women and infants and can provide inpatient surgical care or routine outpatient office visits under one roof in a comfortable, family-friendly atmosphere.

Several entities recently have recognized the Women and Infants Center and the Department of Obstetrics and Gynecology for milestones and awards for the quality of research and care they provide.

The Continence and Urogynecology Care Clinics earned reaccreditation as a Center of Excellence for continence care by The National Association for Continence, a designation based on evidence of extensive training, clinical experiences, resources and patient-satisfaction statistics that meet established standards.

The Department of Obstetrics and Gynecology also was selected as a recipient of the 2014 Roy M. Pitkin Award, which recognizes the department’s promotion of and excellence in research that ultimately will improve the health care of women.

“We are honored to have been recognized for our efforts, and we will continue to strive for excellence in care for the women of Alabama,” Andrews said.

The UAB kidney chain, which began December 2013 and expects more transplants in January 2015, ‘showcases the power of the human spirit in every aspect.’

“This will be my first time to be a healthy person. You don’t know what that means. It’s hard to describe what that means. I just know I’m looking forward to it, and I can’t wait,” said Thompson.Tommy Thompson was born in December of 1973 with a horseshoe kidney, a condition in which the kidneys fuse together at the lower end during fetal development. It’s a debilitating disorder that led to more than 40 surgeries of different types for Thompson by the time he was a young adult. Some of the surgeries were aimed at correcting the condition; others were an attempt to make dialysis possible so he could stay alive.

Finally, on Dec. 19 in UAB Hospital at the University of Alabama at Birmingham, at age 41, Thompson had the surgery he has needed most — a living-donor kidney transplant. Thompson received his kidney through UAB’s record-breaking kidney chain. The chain, which began in December 2013, has matched 34 living donors with 34 recipients to create the longest kidney-transplant chain ever recorded in the United States; previously, the longest chain on record involved 30 donors and recipients in 17 hospitals around the country. All 34 recipients in the UAB kidney chain have been transplanted at UAB Hospital or Children’s of Alabama.

In Thompson’s case, the transplant is a prayer that the minister from Cantonment, Florida, says has been answered.

“One of the reasons this transplant is so special to me is that I’ve never been a healthy dad. I’ve never been a healthy husband or preacher,” Thompson said. “This will be my first time to be a healthy person. You don’t know what that means. It’s hard to describe what that means. I just know I’m looking forward to it, and I can’t wait.”

Thompson’s transplant was made possible the same way the previous 33 transplants in the chain were — by the selflessness of a total stranger. Thompson received his kidney from 38-year-old Chicago, Illinois, native Linda Hessenberger, who donated on behalf of her aunt, Cathy Vandiver of Tuscumbia, Alabama. Vandiver received her kidney from Mobile, Alabama, native Felisa Goodwin on Dec. 11.

“My Aunt Cathy is not one to complain, and I didn’t really know how bad she needed a kidney until I was visiting my mom this past summer,” Hessenberger said. “But Cathy told us what was going on, and it really bummed me out. I filled out the information online to be a potential donor, and they contacted me to come in and be tested, and everything went pretty quickly after that. It was just something I felt like I had to do; it was something I wanted to do. The fact that I got to help my aunt and someone else by donating on her behalf … is just awesome. It just makes it that much more special.”

A desire and willingness to help others is the reason this chain has reached a record 34 transplants, says Jayme Locke, M.D., surgical director of the Incompatible Kidney Transplant Program in UAB Hospital and coordinator of the chain.

"It was just something I felt like I had to do; it was something I wanted to do. The fact that I got to help my aunt and someone else by donating on her behalf … is just awesome. It just makes it that much more special,” said Linda Hessenberger, left, with Aunt Cathy Vandiver.“From the very beginning, this chain has represented a real sense of community,” Locke said. “Every person involved has wanted to give back and give to others, which is why we have been able to help people beyond what many chains in the country and around the world have ever been able to do. This sense of community and commitment is truly unique, especially here in Alabama and the Southeast. It’s a very powerful story.”

The chain began Dec. 5, 2013, with Pelham, Alabama, resident and donor Paula Kok, who approached UAB about the possibility of donating a kidney to someone in need and was committed to donating a kidney despite not having an intended recipient.

In a paired transplant chain, a donation like Kok’s can set off a series of transplants in which family or friends of recipients give a kidney to another person in need — essentially paying donations forward on behalf of a loved one.

Kok’s altruistic gift launched a chain of transplants that changed the lives of people in nine states — Alabama, Mississippi, Florida, Georgia, Tennessee, Louisiana, Texas, Illinois and New Jersey — and even endured a January snowstorm that crippled the Southeast the week of Jan. 27.

Kok’s decision to donate to someone — anyone — in need still resonates with donors and recipients a full year later.

“It’s a very selfless thing for someone to come forward and be willing to donate to start something like this,” said John Woolard, the 33rd donor in the chain. “That is a huge commitment, which undoubtedly makes an impact on others. Following after someone is easier oftentimes than taking the first step. It’s a testament to God’s grace and His example of how He can use one person to reach many.”

Selwyn Vickers, M.D., senior vice president for Medicine and dean of UAB’s School of Medicine, says the kidney chain highlights UAB’s commitment to academic excellence and clinical innovation for lifesaving treatments that reach beyond standard clinical techniques. “The goal of our programs,” he said, “is to have a resounding impact on health care across the country. This kidney-transplant chain demonstrates our pledge.”

“This chain really showcases the power of the human spirit in every aspect. Every one of these individuals involved possesses special gifts — determination, love for their fellow man, a thirst for knowledge and passion. These are precious gifts that encapsulate the very essence of life. Our entire staff is honored to serve these families and be a part of each of their journeys.”

Vickers also pointed to the hard work and dedication of numerous surgeons, nephrologists, nurses, kidney-transplant coordinators and support staff as an instrumental part of the success of the incompatible kidney-transplant program. Vickers says this devotion, along with the perseverance of the transplant recipients, donors and their families, made this chain possible.

“What has been accomplished with this chain speaks to the commitment of numerous people — especially the transplant recipients, donors, and our entire UAB transplant surgical, clinical and research teams,” Vickers said. “This chain really showcases the power of the human spirit in every aspect. Every one of these individuals involved possesses special gifts — determination, love for their fellow man, a thirst for knowledge and passion. These are precious gifts that encapsulate the very essence of life. Our entire staff is honored to serve these families and be a part of each of their journeys.”

Sixty-seven of the 68 surgeries in the chain to date have been performed at UAB Hospital. One recipient, 15-year-old Ryane Burns of Union, Mississippi, was transplanted at Children’s of Alabama, making it the only program in the Southeast to offer living-kidney paired donation to recipients younger than 18.

UAB’s program — the South’s leading incompatible kidney-transplant program — makes transplantation possible between some donors and recipients who otherwise would not match. It also fills a major need in Alabama, where more than 3,700 men, women and children are on the nation’s second-largest waiting list for a kidney transplant.

Living-donor kidney transplantation is not rare, but many programs require a completely compatible match. Consequently, many of the transplants UAB surgeons perform, including several in this chain, would not have occurred through a national paired-exchange program. UAB’s program offers patients pretreatment to overcome blood group and/or HLA barriers to compatibility. Paired donations also improve compatibility and make the transplants less challenging. UAB’s program of combining desensitization with paired donation is unique in the Southeast.

“UAB has become a national leader in kidney transplantation since performing our program’s first kidney transplant in 1968,” said Devin Eckhoff, M.D., director of UAB’s Division of Transplantation. “Our kidney program has done more living-donor transplants than any other program in the United States since 1987, and it is one of the three largest kidney-transplant centers in the nation. Our experience in performing kidney transplants from living donors ensures the highest level of care and better outcomes for our patients — both kidney donors and recipients.”

The chain doesn’t end with Thompson; more transplants are planned in January 2015. Denise Prewitt is a bridge donor who is expected to be part of the chain in the New Year. She is donating on behalf of Marjorie Wilhite who received her kidney this past summer.

“I’m excited and ready to help when it’s my turn,” Prewitt said. “This chain is just amazing to me, totally wonderful. I’ve always been a blood and plasma donor. Anything I can do to help is just an honor.”

Thompson, for one, says he will always be grateful to those who chose to give before and after him.

“I think this chain goes to show that we never know the power of the one life we have, how many people you can touch,” Thompson said. “It’s amazing to know that all of these transplants come from one person who was willing to give of herself. That’s just a powerful thought. To know that in your one life, you can touch so many.”

“I was within hours of death when they brought me in. All my organs were failing — lungs, heart, kidneys, everything,” Morgan later recalled.

Unconscious and suffering from extreme carbon monoxide poisoning, she did not realize her situation at the time. Her family told her the tale in the following weeks, a tale that first began with a borrowed RV in which she and husband Craig had joined friends from their home in Tennessee at the NASCAR race in Talladega, Ala.

“We drove down Friday, Oct. 18,” she said. “We got there in the early afternoon, hung out with everybody, had a shrimp boil that night and went to bed. And that’s the last thing I remember until I woke up at UAB 10 days later.”

During the night, carbon monoxide filled the RV, likely from a faulty generator. Craig Morgan did not survive. Allison Morgan was found by friends the next morning, and paramedics on the scene had her airlifted to UAB, the only level-one adult trauma center in the state. It was touch-and-go.

“She was experiencing multiorgan failure, and traditional therapy by means of a mechanical ventilator could not get enough oxygen into her body,” said Enrique Diaz, M.D., associate professor in the Division of Pulmonary, Allergy and Critical Care Medicine. “She was going to die that night.”

There was one last option — ECMO, or extra corporeal membrane oxygenation. ECMO is a technology using a portable heart/lung bypass machine originally developed for heart surgery.

ECMO takes on the function of the heart and lungs by routing the patient’s blood into the machine where carbon dioxide is removed and oxygen is added. The blood is then pumped back into the body.

ECMO takes on the function of the heart and lungs by routing the patient’s blood into the machine where carbon dioxide is removed and oxygen is added. The blood is then pumped back into the body.

ECMO is not without risk. Diverting the blood from the veins to the tubing that carries it to the machine and then back to the arteries requires a surgical procedure. Patients on ECMO require careful around-the-clock monitoring.

“Dr. Diaz told my family that there was a chance I could die during the procedure, but I was certainly going to die without it,” Morgan said.

With the family’s consent, Diaz, who heads UAB’s ECMO program, put Morgan on the machine. She survived the procedure and stayed on ECMO for seven days. The support provided by ECMO allowed her heart and lungs to rest and recover. Her other organs responded and recovered as well, and Diaz was able to wean her from the machine.

“There’s no question he and my family made the right decision,” Morgan said. “If they hadn’t, I wouldn’t be here. Dr. Diaz said when they made the decision to use ECMO I probably had two hours to live.”

Diaz says there is virtually nothing in the medical literature chronicling the use of ECMO for carbon monoxide poisoning, and such use is rare. The technology is not new, but Diaz says improvements in recent years have made it a more viable option for a variety of heart and lung injuries.

“This technology has improved over time, and there have been many advances in the machines that have made ECMO much safer with wider applications,” he said.

ECMO is used during heart surgery and as a bridge to heart or lung transplant. Diaz and his team have used ECMO to treat nearly 20 patients with severe influenza this winter. He says it is now an option for patients with severe lung injury or heart issues such as cardiogenic shock.

The other key to successful use of ECMO is the expertise of a dedicated team of professionals, including critical care physicians and nurses, surgeons, perfusionists, and respiratory and physical therapists. ECMO machines, and the team that knows how to use them, are typically seen only in large hospitals such as UAB, with major critical care, transplant and trauma programs.

After a month at UAB, Morgan went home. Diaz expects her to have a complete recovery. At her first follow-up visit a month later, her heart and kidney function was back to normal, and her lung function was improving dramatically.

After a month at UAB, Morgan went home. Diaz expects her to have a complete recovery. At her first follow-up visit a month later, her heart and kidney function was back to normal, and her lung function was improving dramatically.

“People would say to me that I must really be a fighter, but I told them I had to survive,” said Morgan. “I’ve got a 4-year-old at home, and she needs me. She lost her father, so she needs her mother.”

Morgan is still coping with the loss of her husband. She was in intensive care at UAB and on ECMO during his funeral. She continues to mend both emotionally and physically, with a big boost from daughter Carly.

“I was released from the hospital Nov. 20, and Carly turned 4 on Nov. 21,” she said. “We had a party already planned for her for Nov. 23, so it was a really happy homecoming for me. It is unbelievable how many different things had to fall into place for me to still be here. The fact that they found me just in time, that they got me to UAB, where doctors were capable of saving my life with ECMO: all of that had to fall into place for me to survive.”

Morgan also credits family and friends, who organized around-the-clock shifts to have someone at her bedside while she was at UAB.

“There was just amazing support around me from my extended family, from friends and from UAB staffers, and that’s part of the reason that I’ve recovered as well as I have,” she said.

At her follow-up visit with Diaz, Morgan brought something special, a photo of Carly and herself taken at the birthday party. She delivered thank-you cards and copies of the photo to hospital staff who had cared for her.

“My message to them was — you made this possible. You made it possible that I could get home in time for her birthday, and hopefully many more birthdays to come.”

Hospitals remain alert and ready after a confirmed U.S. hospital-identified case of imported Ebola associated with the ongoing West African outbreak makes news in Dallas.

The first case of Ebola diagnosed in the United States and associated with the ongoing West African outbreak was confirmed this week and triggered increased awareness and concern.

Infectious disease and emergency medicine experts at the University of Alabama at Birmingham say they are prepared for Ebola, as well as other illnesses or emergency situations that might develop.

Ebola is a rare and deadly disease that is found in several African countries. The 2014 Ebola outbreak in West Africa is the largest in history and the first Ebola epidemic the world has ever known, according to the Centers for Disease Control and Prevention.

On Sept. 30, the CDC confirmed the diagnosis of Ebola in a person who had traveled from West Africa to Dallas.

“We take any potential threat to patients, their families, hospital visitors and our own health care workers very seriously,” said Bernard Camins, M.D., M.Sc., associate professor of medicine and health care epidemiologist for UAB Hospital. “From the moment we learned of the outbreak of Ebola virus disease in Africa, key UAB hospital stakeholders made preparations based on CDC recommendations in case a patient here presented with symptoms of having the virus.”

Following development of specific guidelines, hospital employees have practiced response to a potential Ebola case.

“We have a tiered system of medical professionals and first responders who have anticipated and planned for just about any situation that could affect our area,” said Sarah D. Nafziger, M.D., associate professor in the UAB Department of Emergency Medicine and assistant state emergency medical services medical director for the Alabama Department of Public Health.

When patients arrive in the UAB Hospital emergency department, they are immediately triaged. If they have any of the symptoms consistent with Ebola and have traveled to an Ebola-active area in Africa in the past 21 days, they are immediately isolated.

Health care workers take extra precautions when evaluating these patients, as recommended by the CDC.

The triage process was developed by the UAB Emergency Management Committee with guidance provided by the CDC.

“We have a tiered system of medical professionals and first responders who have anticipated and planned for just about any situation that could affect our area,” said Sarah D. Nafziger, M.D., associate professor in the UAB Department of Emergency Medicine and assistant state emergency medical services medical director for the Alabama Department of Public Health.

“Our Emergency Management Committee is charged with preparing for any event that might develop, including Ebola, and we plan on different contingencies and all possibilities, whether for one patient or many patients, so that we can be best prepared.”

Nafziger says in addition to handling the affected patient or patients, the committee also looks at how to address panic that could arise.

“As health care leaders, we need to be able to educate the public and help to minimize anxiety appropriately,” she said.

In addition to the internal resources available, whether they be supplies or the right people in place to implement a plan and respond to a situation, UAB also takes part in the Jefferson County Health Care Coalition, consisting of the county health department, area hospitals, EMS providers and other key groups. This coalition, Nafziger says, meets on a regular basis, compares hospital plans and discusses equipment needs, such as portable containment units.

“In Jefferson County and at UAB, we have shown in previous incidents like the April 2011 tornadoes that our hospital will be ready, and our people will respond appropriately,” Nafziger said. “We saw 340 patients in the emergency department from the tornado outbreak, with 41 Level One trauma patients. We’ve planned for just about anything and everything, and are prepared for any eventuality.”

Because of the medical resources available, and the fact that Ebola is not spread through the air, or by water or food, the risk of an Ebola outbreak in the U.S. remains low, says David O. Freedman, M.D., head of the UAB Travelers’ Clinic.

“It would be very unlikely for Ebola to become a big problem in the United States,” Freedman said. “Even if we had an accidental case of it being transmitted to a health care worker or family member, it’s unlikely to be widespread because of the response and resources we have. So it would be very hard for it to become a major situation and affect dozens or hundreds of people at a time.”

The UAB Travelers’ Clinic sees people both prior to and after international travel. He says an ongoing alertness at the hospital and his own clinic will remain, and that UAB is positioned well for whatever may emerge.

To support communication between doctors and patients, UAB Medicine has deployed interactive post-discharge phone calls and corresponding multimedia programs that encourage patients’ additional learning about their health condition to improve care transitions and reduce readmission rates.

UAB Hospital Chief Quality Officer Benjamin Taylor, M.D., MPH, says transitioning from hospital to home is an important step during recovery, and proper monitoring paired with self-management is essential.

“We are focused on extending communication beyond the four walls of the hospital, to not only share valuable instructions but also monitor patient care,” Taylor said. “Being a part of our patients’ path to wellness doesn’t end when they leave our hospital.”

Personalized, automated phone calls deliver and reinforce necessary instructions, as well as collect data on patients’ status to ensure recovery is progressing. As people often also need the help of their family or friends, the calls and programs can be extended to other individuals whom the patient requests.

Simple language and compelling multimedia visuals accessible via computer or mobile device are used to make sense of complex medical information, and the programs and campaigns provide empathetic, understandable and actionable information to foster patient compliance and follow-through, as well as make care conversations more impactful.

To support communication between doctors and patients, UAB Medicine has deployed interactive post-discharge phone calls and corresponding multimedia programs that encourage patients’ additional learning about their health condition to improve care transitions and reduce readmission rates.

“As a national leader in patient experience, UAB recognizes that proactive outreach is a pillar of providing the highest-quality care,” said Devin Gross, CEO of Emmi Solutions, a leader in outcomes-driven patient engagement that collaborated with UAB on the initiative. “Beyond delivering recovery instructions, our call campaigns track patient feedback and facilitate targeted outreach, enabling UAB’s care staff to utilize their resources efficiently, reaching out to patients at risk for readmission who require intervention the most.”

UAB Medicine comprises the School of Medicine and the $3 billion UAB Health System that includes 2,300 licensed beds in six hospitals, one of which is UAB Hospital — the third-largest public hospital in the United States, winner of the Women’s Choice award, and one of U.S. News and World Report’s Best Hospitals.

The University of Alabama at Birmingham and the American Red Cross will hold a blood drive from May 5-15 with a nod to summer, beaches, boat drinks and Parrotheads. The music of Jimmy Buffet and nonalcoholic margaritas will set the stage for a visit to Donorville. A special, colorful ‘Saving lives in Parrot-ise’ T-shirt will be given to all donors, who will also be entered in daily drawings for a $100 gift card.

The drive runs at the UAB Hospital North Pavilion second-floor atrium May 5-10, and at UAB Highlands Hospital on May 13-15.

All blood types are needed. Donors should bring a photo ID. Free parking is available in the North Pavilion parking deck and the UAB Highlands parking lot.

UAB is one of the largest users nationally of blood supplied by the Red Cross. Donors can give blood up to six times a year, once every eight weeks. The process takes about 45 minutes; the actual blood collection usually takes less than 20 minutes.

Blood products are used during surgery, transplantation, trauma care, difficult pregnancies and cancer treatment. It is not unheard-of for a single patient to require as many as 100 units.

University of Alabama at Birmingham Hospital has received the 2014 Outstanding Patient Experience Award from Healthgrades.

Healthgrades identified 447 hospitals that scored in the top 15 percent on the Center for Medicare and Medicaid Services patient experience survey. Healthgrades analyzed Hospital Consumer Assessment of Healthcare Providers and Systems survey results for 3,939 U.S. hospitals. The surveys included in the analysis were completed between April 2012 and March 2013.

“Compared to those at other U.S. hospitals, the recipients of the Healthgrades Outstanding Patient Experience Award have demonstrated that they excel in ways their patients value most,” said Evan Marks, Healthgrades’ executive vice president of strategy and informatics. “Our analysis shows that the personal impact of caregiving — like responsiveness to needs, communication and pain control — is what is most important to patients.”

UAB Hospital has been named by Becker’s Hospital Review among the 2014 “100 Great Hospitals in America,” a compilation of some of the most prominent, forward-thinking and focused health care facilities in the nation.

Hospitals included on the list are home to many medical and scientific breakthroughs, provide best-in-class patient care, and are stalwarts of their communities, serving as academic hubs or local mainstays.

“Patients come to UAB Hospital from our local communities, throughout Alabama, across the country and around the world,” said UAB Medicine COO Reid Jones. “We are pleased that the Becker’s Hospital Review has included us in this prestigious group. Our physicians and staff strive to provide the highest-quality care to the patients we serve. Guided by our strategic plan, we are working to be among the most preferred academic medical centers in the country.”

Consistently listed among the top medical centers in the country and the only Birmingham hospital included in the list, UAB Hospital is the largest hospital in Alabama and third-largest public hospital in the nation. Its landscape includes the Kirklin Clinic of UAB Hospital, a “superclinic” for outpatient care, and it sits among major research centers and serves as a model in design innovation for hospitals of the future. A Magnet-designated Center of Excellence, UAB Hospital is also ranked annually as one of America’s Best Hospitals by U.S. News & World Report.

Becker’s Hospital Review’s editorial team conducted research, considered nominations and evaluated reputable hospital ranking sources, such as U.S. News & World Report, Truven Health Analytics’ 100 Top Hospitals, Healthgrades, Magnet designation by the American Nurses Credentialing Center, The Leapfrog Group, and several other resources.

UAB Hospital has been named one of America’s best breast health centers by WomenCertified, Inc.

University of Alabama at Birmingham Hospital has been named one of the 2014 America’s Best Breast Centers by WomenCertified, Inc., home of the Women’s Choice Award. The Women’s Choice Award is reserved for hospitals across America that partner with WomenCertified in its mission to empower women to make smart health care choices. The distinction is the only award that identifies the country’s best health care institutions based on robust criteria that consider female patient satisfaction, clinical excellence and what women say they want from a hospital, including quality physician communications, responsiveness of nurses and support staff, cleanliness, and trusted referrals from other women.

88-year-old, 100th UAB TAVR patient, is ready to have her “get-go” back.

At age 88, Lena M. Smith was not surprised to be slowing down, but it did not mean the Birmingham resident had to accept it without investigating whether there was something more than age at play. She visited her doctor, Larry Hunt, M.D., in January at the University of Alabama at Birmingham to find out why her energy level had diminished.

Hunt, a primary care physician and assistant professor in the UAB School of Medicine, detected a heart murmur, and an echocardiogram confirmed aortic stenosis. Smith needed her aortic valve replaced. UAB Heart and Vascular Services cardiothoracic surgeon Spencer Melby, M.D., and interventional cardiologist Seun Alli, M.D., scheduled Smith for the minimally invasive Edwards Lifesciences SAPIEN transcatheter heart valve replacement system surgery, and she became the 100th patient to undergo the procedure at UAB Hospital since the program began in August 2012.

UAB is home to the state’s largest and oldest heart valve disease treatment program and is one of just a few in Alabama trained to offer the Edwards Lifesciences TAVR — the only transcatheter aortic valve replacement therapy approved for commercial use in the United States.

UAB is home to the state’s largest and oldest heart valve disease treatment program and is one of just a few in Alabama trained to offer the Edwards Lifesciences TAVR — the only transcatheter aortic valve replacement therapy approved for commercial use in the United States. UAB performs more valve procedures annually than anyone in the state and has since the inception of its program.

UAB completed its 100th TAVR transplant in 18 months. Many programs around the country complete approximately 50 TAVR procedures in the same time period.

“We have had great success since we began doing the TAVR procedure, and a big reason for that is that we have a tremendous team in place,” Alli said. “In many cases, these are really sick people who don’t have a lot of other options. Open-heart surgeries just aren’t possible because of the age or other medical issues of the patient in most cases. But we’ve done 100 of these cases with minimum complications, and we’ve had very good outcomes. We’ve seen that when they come back to clinic for follow-up they are symptomatically better and have an improved quality of life.

“This is a revolutionary type of procedure, and we have the best-trained group to do it,” Melby said. “We’ve done the most in the state, and we have a good team approach. We work well together in helping our patients add life to their years, not just years to their lives.”

The big advantage to the TAVR procedure is that surgeons can replace valves without open-heart surgery, which is the gold standard of treatment for most patients. At Smith’s age, that was not the best option.

Smith’s daughter, Carolyn Hagerman, knew something had to be done to help her mom, who she says was always on the move.

That is how Hagerman and others knew something was not quite right with her mom prior to the procedure. Church members began telling Smith she seemed to be slowing down, which was odd to them. After all, Smith has exercised regularly for the past 48 years.

Smith also regularly cooked all day on Saturdays so she would have her meals ready for the entire week.

“She’s truly like the Energizer bunny,” Hagerman said. When her mom began having trouble with routine lifting of pots and pans, Hagerman told her it was time to talk to Hunt.

“I was losing my get-go,” Smith said. “My daughter told me to ask the doctor to give me something to speed me up because I was slowing down. Dr. Hunt said they were going to check on me to see what is causing my problems. I’m so glad they were able to figure it out so quickly.”

This event is not Smith’s first positive experience at UAB with a life-threatening issue. She was diagnosed with breast cancer in 1998 and beat it with the help of treatment from UAB.

“I’ve always said if something should happen where I die in this hospital, I will know and believe that everything that needed to be tried to save me will have been done,” Smith said.

As for Smith’s plans this time, they are the same as they were when she left UAB Hospital 15 years ago.

“I’m going to go back home, keep exercising and keep working as an usher at my church,” Smith said. “I’m going to enjoy life.”

UAB is currently the top site in Alabama to offer a special CTO procedure, which helps patients avoid the more invasive open-heart surgery – but the resource is not widely known.

Paul CummingsSeventy-year-old Paul Cummings is not someone who enjoys down time. The Pensacola, Fla., resident and Hueytown native worked for Delta Air Lines for 29 years before retirement, which enabled him to further engage in his passion for painting.

So when Cummings’ chest started hurting a couple of years ago, and he began gasping for air after walking no more than a few steps across a room, he knew he had a real problem.

“I got to the point where I didn’t know where my next gasp of breath was going to come from,” Cummings said. “It’s rough when you can’t walk 10 feet without getting out of breath — real rough.”

The cause of Cummings’ chest pain and breathing discomfort was a complete blockage of a coronary artery, also known as a chronic total occlusion, or CTO. This condition is responsible for a significant decrease in blood flow to the heart caused by a heavy atherosclerotic plaque buildup within the artery, resulting in a complete occlusion of the vessel.

The University of Alabama at Birmingham's nationally ranked Heart and Vascular Services is among the few heart centers in the United States to use a new minimally invasive method to unblock chronic total occlusions for the treatment of refractory chest pain. The new treatment may help prevent qualifying patients from needing bypass surgery, which is more invasive and involves a longer recovery time. If the patient cannot undergo bypass surgery, he or she may be relegated to a life of daily chest pain.

From right: Cummings and LeesarThe treatment, called percutaneous coronary intervention of chronic total occlusions, involves using different devices and wires to cross the stenosis and open the totally occluded heart artery effectively and safely. A balloon catheter is then advanced across the lesion to break up the blockage, and a stent is inserted, reopening the artery.

Cummings was one of the first patients at UAB Hospital to undergo the procedure, in June 2013. Today, he says he is as healthy as he has been in years.

“I first started having shortness of breath two years ago, and I went on medication for a while and then had a heart attack in Florida when they ultimately tried to put a stent in,” Cummings said. “When we came to UAB, the doctor examined me and said, ‘We can fix this by drilling through the plaque and placing a stent in.’ Obviously, I was a little apprehensive at first; but this procedure has just been amazing. I knew I needed somebody that did cutting-edge things, and I’m glad I was able to come to UAB.”

UAB’s team has completed more than 20 CTO procedures, and the success rates fall right in line with the few other hospitals around the country that have completed more than 1,000 of these cases, says Massoud Leesar, M.D., professor of cardiovascular disease in UAB’s School of Medicine.

“The industry is into the third iteration of this CTO technology, and we have new devices and wires that make a huge difference in our success rates,” said Leesar, the cardiologist who performed Cummings’ procedure. “In the past, success rates were around 50 to 60 percent. Now, it’s closer to 80 to 90 percent. So while it is a procedure that takes some time — in rare cases up to four hours — it also takes a lot of effort and expertise. But whatever it takes, we’re here to do it.”

Mark SasseThe fact that UAB can do these CTO procedures is not well-known among many cardiologists and general practitioners in Alabama, says Mark Sasse, M.D., associate professor of cardiovascular disease in UAB’s School of Medicine and one of several hospital interventional cardiologists who can perform the procedure. Sasse says general cardiologists do not know that CTOs can even be opened in some cases, and that they often recommend those patients for bypass surgery or medical management of their coronary artery disease.

“The dissemination of this knowledge about the CTO technology has been kind of limited,” Sasse said. “These are procedures that take a longer time than a more straightforward stent procedure, and it takes a dedicated staff like you would find at an academic center. Thankfully, because of the hyperspecialization we have in UAB Hospital, we can do a lot more of these types of procedures than the average interventionalists.”

Cummings is certainly grateful. He worked part time for Procter & Gamble this past year and logged almost 1,000 hours of installing equipment in restaurants in 2013 after his procedure.

A former art major in UAB’s School of Education in 1974, and charter member and past president of the UAB Art Club, Cummings also continues to engage his painting passion every Tuesday at the Quayside Art Gallery in Pensacola, where he is president of the Pensacola Art Studies Club. His wife, Norma, bought him watercolor lessons for Valentine’s Day in 2013, and he’s doing his best to improve.

The University of Alabama at Birmingham and the American Red Cross will hold a blood drive from Feb. 17-27 to celebrate the Sochi Olympics and help boost blood supplies reduced by recent bad winter weather.

Winter storms across the nation in January caused widespread disruption of normal blood donation patterns, leading to low blood stocks in many hospitals.

The drive runs at the UAB Hospital North Pavilion second-floor atrium Feb. 17-22, and at UAB Highlands Hospital on Feb. 25-27.

All blood types are needed. Donors should bring a photo ID. Free parking is available in the North Pavilion parking deck and the UAB Highlands parking lot. Each donor will be entered for a chance to win one of six $100 gift cards.

UAB is one of the largest users nationally of blood supplied by the Red Cross. Donors can give blood up to six times a year, once every eight weeks. The process takes about 45 minutes; the actual blood collection usually takes less than 20 minutes.

Blood products are used during surgery, transplantation, trauma care, difficult pregnancies and cancer treatment. It is not unheard-of for a single patient to require as many as 100 units.

“They volunteer throughout the hospital, UAB Highlands, Callahan Eye Hospital and the Kirklin Clinic,” said Carolyn Matthews, volunteer coordinator for UAB Guest Services. “Our volunteers help lighten the load for our employees to focus even more on patient- and family-centered care.”

Volunteers are on duty for four weeks, answering the phones, handling paperwork, filling supply orders and sometimes a bit more.

“They may get to watch a bedside procedure or have the opportunity to shadow a nurse or physician, which is really helpful for our teens who are interested in the medical field,” said Matthews.

Many are considering a career in health care, and volunteering gives them a taste of what to expect.

“When I first volunteered, I was thinking I’d like to be a doctor or a nurse; I thought those were the only options,” said second-year volunteer Leah Bostany, who will attend Auburn University in the fall. “After being in the setting and seeing all of the different members of the team, I’m thinking about becoming a Registered Nurse First Assist (RNFA) or Certified Registered Nurse Anesthetists (CRNA). Those were two options that I didn’t know existed before.”

Michael Liptrot, a junior at the Jefferson County International Baccalaureate School, wants to be a neurosurgeon.

“My first year, I volunteered in the radiology department with the MRI machine,” he said. “My second year, I worked in the echocardiography lab, basically ultrasound of the heart. I am in surgical pathology this year. I have been able to meet and talk with a lot of physicians.”

First-year volunteer Steven Breaux, a senior at Spain Park High School, also plans to be a physician.

“I just wanted to see what everyday life would be for a doctor and for other people working with doctors,” he said.

For second-year volunteer Devin Sun, a senior at the Alabama School of Fine Arts, medicine is the family business.

“My sister is in medical school at UAB, and both of my parents work at UAB,” said Sun. “Hopefully, I’ll be working at UAB in a few years.”

Assistant professor of nursing Darnell Williams, DNP, followed that route, serving as a teen volunteer when the program started in the early 1990s.

“My mom is a nurse, too, and she encouraged me to volunteer at the hospital to see if that was truly what I wanted to do,” said Williams. “It definitely solidified my rationale for why I wanted to be a nurse, seeing the compassion that nurses had while taking care of the patients.”

Williams went to nursing school at UAB, worked as an RN at UAB Hospital and eventually earned her doctorate in nursing practice. She now teaches on the faculty of the UAB School of Nursing. Her experiences as a teen volunteer helped prepare her for the academic rigors of school.

“I definitely was able to draw from the experiences that I had as a volunteer, seeing the nurses and the whole health care team working together to help the patient,” she said. “I knew that they had to go through similar academic challenges to get to where they were. So that really did help me to know that they were able to do it, and I could do the same.”

Matthews said one lesson that the volunteers learn is that a hospital is more than just physicians and nurses.

“It takes a team of people: the unit secretary, the patient care tech, environmental services, food and nutrition services and so on,” she said. “It takes everyone, including administration, to make the hospital run efficiently.”

The blood supply nationwide is low, a frequent occurrence in the summer months. With vacation and summer travel, regular collection patterns are disrupted, leaving the Alabama blood supply at below optimum levels, say blood supply officials at the University of Alabama at Birmingham (UAB) and the American Red Cross.

UAB and the Red Cross will hold a blood drive July 8-18. The drive, “Hunting for Donors,” offers a safari-style theme. The drive runs at UAB Hospital North Pavilion, second floor atrium, July 8-13 and at UAB Highlands Hospital July 16-18. All blood types are needed.

Each donor will be entered for a chance to win an iPad or Kindle Fire HD.

Drive hours at the North Pavilion, 18th Street and 6th Ave. North, are:

Monday, July 8, 10 a.m.-5 p.m.

Tuesday, July 9, 10 a.m.-5 p.m.

Wednesday, July 10, 7 a.m.-2 p.m.

Thursday, July 11, 10 a.m.-5 p.m.

Friday, July 12, 10 a.m.-5 p.m.

Saturday, July 13, 10 a.m.-5 p.m.

Hours at UAB Highlands, 1201 11th Ave. South:

Tuesday, July 16, 9 a.m.-3 p.m.

Wednesday, July 17, 6:30 a.m.-12:30 p.m.

Thursday, July 18, 11 a.m.-5 p.m.

Donors should bring a photo ID. Free parking is available in the North Pavilion parking deck and the UAB Highlands parking lot.

UAB is one of the largest users nationally of blood supplied by the Red Cross. Donors can give blood up to six times a year, every eight weeks. The process takes about 45 minutes; the actual blood collection usually takes less than 20 minutes.

Blood products are used during surgery, transplantation, trauma care, difficult pregnancies and cancer treatment. It is not unheard of for a single patient to require as many as 100 units.

UAB joins a CDC effort to reduce hepatitis C infection through a screening program in the emergency department.

The Emergency Department at the University of Alabama at Birmingham (UAB) Hospital will begin testing baby boomers for the hepatitis C virus (HCV) in August 2013. All patients born between 1945 and 1965 who present at the ED for any cause will be offered a blood test for HCV as part of their routine examination.

The testing is part of a Centers for Disease Control and Prevention (CDC) initiative designed to identify patients with HVC and get them into appropriate treatment. The CDC estimates that one-time testing of all Baby Boomers could detect 800,000 additional people with hepatitis C and save more than 120,000 lives because 75 percent of these infections are curable with new treatments.

“We anticipate screening between 8,000 and 12,000 Baby Boomers for HCV in 2013 and expect to identify between 260 to 400 new cases of HCV infection at UAB,” said James Galbraith, M.D., associate professor of emergency medicine and head of the UAB HIV and HCV screening programs. “The overall target is the approximate 3.2 million people in the United States who the CDC estimates have chronic hepatitis C virus infection — many of whom are unaware they are infected because they don’t look or feel sick.”

Hepatitis C is a contagious liver disease that ranges from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It is spread primarily through contact with the blood of an infected person. Today, most people become infected with the virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C also was commonly spread through blood transfusions and organ transplants.

The HCV screening program mirrors a similar ED-based program at UAB Hospital to screen for HIV, the virus responsible for AIDS. That program, which began in August 2011, screens for the presence of HIV in all willing adult patients ages 18-65 seeking treatment at the UAB Emergency Department. Of the more than 30,000 screened, Galbraith says the program has identified and referred to treatment more than 150 people who were HIV positive.

The CDC estimates that one-time testing of all Baby Boomers could detect 800,000 additional people with hepatitis C and save more than 120,000 lives because 75 percent of these infections are curable with new treatments.

Patients testing positive for HCV will be linked to appropriate antiviral treatment services through the UAB Liver Center, Liver Transplant Clinic and 1917 Liver Clinic. A linkage coordinator will also help positive HCV cases establish a primary care physician to maintain consistent health care throughout the progression of their disease. UAB Charity Care services will help patients with limited resources obtain appropriate medical care.

UAB ED nurse manager India Alford, RN, says the program will not disrupt patient care in the Emergency Department.

“Patients in the Baby Boom generation will be electronically identified at registration and the patient’s nursing provider will conduct a required HCV assessment,” Alford says. “During the brief three-item assessment, nursing providers will notify the individuals about the CDC’s recommendation and the screening will be available at no cost.”

Unless they refuse, an automated HCV antibody assay will be ordered for eligible patients unaware of their HCV status. Results of the HCV assay will be available within 30 minutes and delivered to patients prior to discharge.

“These day-to-day screening operations would not be possible without the dedicated support of the ED nursing and laboratory staff,” Galbraith says.

More than 5,000 people responded to the magazines’ online survey and entered the businesses and services they thought were the best in 81 categories.

The University of Alabama at Birmingham is the Best Family-Friendly Company according to the 2013 Parents’ Choice Awards, a partnership between Birmingham Magazine and Alabama Baby & Child magazine published each spring. More than 5,000 people responded to the magazines’ online survey and entered the businesses and services they thought were the best in 81 categories.

Also tops for UAB, The Women & Infants Center was named Best Birthing Suite and Best Hospital NICU Unit. ArtPlay, the arts education home for UAB’s Alys Stephens Performing Arts Center (ASC) won for Best Kids’ Art Classes. In addition, UAB had a number of runners-up in a variety of categories, including Best Fertility Specialist Janet McLaren, M.D., and G. Wright Bates, M.D.; Best Obstetrician Kim Hoover, M.D.; Best Gynecologist Heather Greer, M.D.; Best Hospital in Which to Give Birth, Best OB/GYN Practice and Best 3D/4D Ultrasound, UAB Women & Infants Center; and Best Kids’ Music Lessons, Best Theatre Group Classes and Best Day Camp, ArtPlay.

Will Ferniany, Ph.D., CEO of UAB Health System, was named one of the “100 Leaders of Great Hospitals in America” by Becker’s Hospital Review. UAB provides the highest quality care to more than one million patients annually in America’s third-largest hospital and its affiliated clinics, and it has been listed among the best hospitals in the nation by U.S. News & World Report. UAB offers the only Level I trauma center in Alabama and the only NCI-designated Comprehensive Cancer Center in a six-state region.

Ferniany has led UAB Health System since 2008. A senior leader in healthcare since 1975, Ferniany came to UAB after serving as associate vice chancellor and chief executive officer of the University of Mississippi Medical Center. He earned his master’s degree in hospital and health administration and doctoral degree in health services from UAB.

Blending invention with necessity, UAB professionals use a little ingenuity to help a patient prepare for a lung transplant.

Medical professionals at the University of Alabama at Birmingham (UAB) took a new technology, added some ingenuity, inventiveness and a plastic helmet, and enabled a 29-year-old cystic fibrosis patient to get a life-saving lung transplant.

After waiting for a transplant for 11 months, Brandon Rylant’s lungs were failing. As 2012 wound to a close, Brandon could no longer expel carbon dioxide. An ECMO (extracorporeal membrane oxygenation) machine, a kind of heart-lung bypass device, could temporarily take the place of his lungs. The machine pumps a patient’s blood out of their body into a tube that passes it through the machine, removing carbon dioxide and adding oxygen. Another tube then returns the blood to the bloodstream.

A patient on ECMO has to be immobile in a hospital bed, tethered by tubes to the bulky machine. But Rylant’s UAB transplant team needed him to walk down the hall to prove he was healthy enough and build strength to undergo the transplant.

UAB had recently acquired two portable ECMO machines intended for uses including transporting a critically ill heart patient on the UAB Critical Care Transport air ambulance.

Only a few medical centers in the nation have reported using these miniaturized versions of the big ECMO machines as a means to keep a lung transplant candidate alive while awaiting transplant. UAB was the first in Alabama to try.

A portable ECMO machine is about the size of a microwave oven and sits on a small, wheeled cart. The tubes fed from an incision in Rylant’s neck to the machine; they had to be safely secured to ensure they would not come out. The first effort led the tubes up and over Rylant’s head secured by gauze, wrapped much like a turban. It was hot, bulky and nobody was very happy with it — time for some creativity.

UAB perfusionist Mat Tyndal thought he had a better option stashed among the gear stored in his basement, gear he uses for his mountain climbing hobby.

Only a few medical centers in the nation have reported using these miniaturized versions of the big ECMO machines as a means to keep a lung transplant candidate alive while awaiting transplant. UAB was the first in Alabama to try.

“I’m a climber and spend a good bit of time wearing helmets,” said Tyndal. “I thought maybe a climbing helmet that would securely encompass the head, tightened down and adjusted so it couldn’t slide around, would give us a firm foundation to put the tubing on.”

He brought in his old red helmet that had been to the top of 21,122-foot Mt. Illimani in Bolivia and the north face of the Grand Teton. After tightly fitting the helmet to Rylant’s head, a few pieces of Velcro secured the tubing to the helmet, and he was on his way. A small army of perfusionists, respiratory therapists and nurses escorted him on his first walk down the intensive care unit. Some pushed the ECMO cart, some kept a careful eye on the tubing, some simply provided a hand or shoulder on which Rylant could brace himself.

“I likened it to choreographing a ballet, as there must have been fifteen of us assisting in the walk,” said UAB Chief of Perfusion Bobby Reed.

Spencer Melby, M.D., one of Rylant’s transplant surgeons, was one of many committed to the exercise.

“It took a bunch of people who were willing to put in the time, effort, coordination and organization to gather up all the machines and equipment and walk Brandon up and down the hall,” said Melby. “We agreed that we’d do what it took to keep him walking and mobile, so he wouldn’t be so far behind the eight ball that he couldn’t recover when donor lungs became available.”

Rylant was now taking daily walks with the helmet and portable ECMO. Ultimately, the team found an even better solution than the helmet to secure the tubing, using the frame of a surgeon’s headlamp. Teamwork and ingenuity led from necessity to invention.

“You have a lot of diverse people at UAB with different experiences, skill sets and even equipment at home,” said Tyndal. “We came up with an idea, and it worked. The helmet was the start of a solution that then led us to a better one.”

After two weeks of daily walks, Melby’s team got the word; lungs that were a match for Rylant were available from an organ donor in New Orleans. Melby flew to Louisiana to retrieve the organs.

On Dec. 12, 2012, Rylant got his new lungs.

“I’ve been great,” said Rylant at a follow-up visit at The Kirklin Clinic the following April. “I’ve been breathing better than I ever have in my whole life. My lungs are clear, and my breathing function keeps going up. My weight keeps going up, so everything is going good.”

The red helmet has been returned to mountain climbing duty, and perfusionists Reed and Tyndal are already using the portable ECMO machine on another lung patient – now with an even better head framework; UAB Orthotics designed and built a unique, custom-fitted flexible helmet for use with the ECMO machine. More invention, even better results.

As for Brandon Rylant, after eleven months in the hospital and two weeks on ECMO, he now walks just about everywhere he can.

“Now people have to wait on me because I enjoy walking so much,” he said. “I guess I get carried away.”

The program, the only one in Alabama, gives students access to state-of-the-art medical facilities including UAB Hospital, the UAB Women’s and Infant’s Center, Kirklin Clinic and Children’s of Alabama. This provides a wide variety of clinical training experiences and a diverse patient population. Student instruction utilizes internationally recognized genetics and teaching faculty to provide a wide-ranging and exciting education in the field of genetic counseling.

Graduates will be well prepared for roles in traditional clinical settings, as well as emerging areas of genetic counseling such as research and laboratory-based genetic counseling. Traditionally, genetic counselors have been in medical settings caring for individuals and families with genetic conditions, disabilities or predisposition to disease.

“I congratulate Ameen and Miranda, as well as the programs and people that nurtured their development,” said UAB President Ray L. Watts. “It is a testament to the outstanding quality of our students, faculty and staff that UAB has produced 13 Goldwater Scholars and five honorable mentions in the past six years. We are extremely proud of their successes.”

“I want to be the physical bridge between the realms of drug discovery and rehabilitation innovation,” said Barghi. “If I could create a therapy or a drug that would be inexpensive and work quickly, then that would be the ultimate success.”

Miranda Collier

Barghi wants to be an M.D./Ph.D., doing university-level research at UAB. His passion for medicine and UAB began as a sophomore in high school when he signed up for the Teenaged Volunteer (TAV) Program at UAB Hospital, and he was assigned to the Center for Psychiatric Medicine. The neuroimages and research in the lab fascinated him, and he wanted more.

He chose rehabilitation medicine because it is one of the few areas that offers positive long-term impacts, which Barghi sees firsthand.

“I once met a veteran U.S. Army Ranger who was missing an arm,” said Barghi. “This huge, tough guy would tear up when his son walked into the lab because he could not interact using his prosthetic arm. Three weeks of therapy, and he was able to hug his wife and pick up his son like it was natural. These are the type of tangible results we get daily.”

“I thought to myself, in 10 years do I want to be prescribing medicine to patients, or do I want to design the medicines that should be prescribed to them,” said Collier.

Collier describes her time in Oxford as a defining experience in her life. Under Benesch’s guidance, she used mass spectrometry, a method of displaying the singular spectrum of the masses of molecules in a protein, to research the structure and behavior of a particular protein complex.

The idea of looking at a complex organism as a whole is also how Collier, a member of the University Honors Program, sees UAB. She is a teaching assistant, co-editor of Inquiro, UAB’s undergraduate science research journal, and she has recently been working with another student to reinstitute the Undergraduate Research Organization to encourage collaboration among student researchers. She wants students, especially freshmen, to know what opportunities are available to them.

“If you just go through school only worrying about yourself, then what’s the point?” she said.

Collier is grateful to UAB faculty for their willingness to help undergraduate researchers.

“I’ve asked professors in chemistry, biology, vision sciences, pharmacology and nutrition sciences if I can work with them or use equipment in their labs, and they have all helped me,” said Collier. “I have learned so much from them.”

UAB has had four Goldwater scholar winners in the last two years. Barghi and Collier are the 16th and 17th UAB students to win, and they are two of only four students in Alabama to win the award for 2013. The magnitude of the award is not lost on Barghi or Collier.

“This award is not necessarily about what you have done, but about your potential and what you can do for the future of science,” said Collier. “I now feel a compulsion, because I have this award to my name, to do it justice. It is gratifying and humbling.”

After 30 years and millions of miles, UAB’s Critical Care Transport Service is still going strong.

It flew 21 patients out of New Orleans when Hurricanes Katrina and then Rita bore down on the Gulf Coast and plucked eight premature babies out of the path of Hurricane Gustav. It travels around the world and down the street to safely transport very sick patients from one hospital to another, to get them to the most appropriate care. It is the Critical Care Transport Service at the University of Alabama at Birmingham (UAB), and it is 30 years old.

In the early 1980s, UAB physicians realized that patients with significant medical issues requiring transfer to UAB for advanced care needed a better transport system than an ordinary ambulance. They needed vehicles with the same kind of equipment found in a hospital intensive care unit (ICU), staffed by the same kind of medical professionals who work in those units.

That need lead to the creation of the CCT, with a jet aircraft – a flying ICU – and three ground ambulances – rolling ICU’s – as well as the critical care nurses, respiratory therapists and physicians needed to make the transfers go smoothly and safely.

“We can go to just about anywhere on the planet if need be, but most of the patients we bring to UAB for the specialized care available through UAB Medicine come from the Southeastern United States,” said Laura Lee Demmons, director of CCT. “It’s a great resource for physicians and patients around the world that we have the equipment and expertise to safely transport patients to UAB.”

Demmons says the first patient – or rather first four patients – were particularly special. They were quadruplet babies born to Debbie and David Tanner at UAB Hospital on March 16, 1983. Debbie had been transferred to UAB due to the difficult pregnancy. The Tanner quads were the first quadruplets born in Alabama to all survive. Seven days later, the CCT made it possible for them to go back to their home hospital.

The team has flown 23 million air miles, driven 6 million ground miles and transported more than 41,500 patients from 48 states and 38 foreign countries since it first took Debbie, Anne Rain, Griffin, Emily and Christopher Tanner on that five-mile trip.

“They asked if I’d like to inaugurate the critical care transport system,” recalled Debbie Tanner. “They wheeled me out to this shiny, new ambulance, and here come the little incubators. It was amazing because we all fit into this big, mobile unit, almost like a stretch operating room.”

The team has flown 23 million air miles, driven 6 million ground miles and transported more than 41,500 patients from 48 states and 38 foreign countries since it first took Debbie, Anne Rain, Griffin, Emily and Christopher Tanner on that five-mile trip.

“I hadn’t even thought about how in the world we would move four babies who are still in incubators,” said Debbie. “We really couldn’t have done it without the transport system.”

The Tanner’s held the CCT record for most patients transported at one time until Hurricane Gustav approached New Orleans in 2008. A hospital there, already without power, called and said they had eight babies in neonatal ICU who needed to be moved.

“We said we normally don’t transport eight babies at once, but the referring physician said, ‘you need to come get these babies or they are not going to make it,’” said Demmons. “So, we went and got eight babies at once.”

There have been other high points. CCT was the first Western medical team to land in Petropavlovsk, Russia. The CTT team once used a gondola as ground transport in Italy. They made multiple flights into ravaged New Orleans after Hurricane Katrina, bringing basic supplies in and flying sick patients out.

CCT is accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS), and it was the first hospital-based transport program in Alabama and the surrounding five-state area to gain such accreditation in 1999. They have contributed more than 24 journal articles, book chapters, position papers, practice standards and research presentations to scientific literature.

Demmons, who started as a registered nurse on the team in the first year of operation, has seen a lot in the ensuing 30 years.

“This is the best job I have ever had and will ever have,” she said. “One physician wrote back after we transported his patient to UAB and said, ‘Your team saved my patient’s life; now he’s home and well.’ That’s what it’s all about.”

CCT’s current jet, a Cessna Citation Bravo, is unique in the field. It is one of the very few medical jets that can carry two adult passengers at the same time. The ground ambulances are designed with patient and crew safety in mind, and they are being refitted to operate on bio-diesel fuel.

UAB is studying a depression drug that may be able to stop suicidal thoughts in their tracks.

University of Alabama at Birmingham (UAB) researchers think ketamine, an anesthesia medication in use since the 1970s, might be a valuable tool in treating severe depression and reducing suicidal urges; they have launched two studies to explore the possibility. One of the studies, ketamine is administered to suicidal patients in the UAB Hospital emergency department (ED), is the only such trial actually being conducted in an ED in the nation.

“There is a growing body of evidence that indicates that lower doses of ketamine can reduce suicidal feelings and relieve symptoms of severe depression in a very short period of time, as little as a few hours, which makes it an extremely attractive candidate for treating acute depression,” said Richard Shelton, M.D., professor in the Department of Psychiatry and Behavioral Neurobiology and lead investigator on the studies.

Shelton said ketamine appears to work on depression by blocking a neurotransmitter called glutamate from binding to the NMDA receptor on neurons. Too much glutamate on an NMDA receptor leads to the opening of a calcium ion channel, releasing too much calcium downstream. This then affects a brain chemical, brain derived neurotrophic factor (BDNF), which increases connections between neurons in the brain. These connections help the brain regulate emotions better.

In the trial, patients presenting to the ED with suicidal thoughts can be enrolled in the ketamine trial. The drug is administered via infusion, which takes about five minutes.

“We have seen a decrease in depression scores and suicide scores, sometimes within 15 minutes after giving ketamine,” said Cheryl McCullumsmith, M.D., Ph.D., assistant professor and director of hospital psychiatry. “The antidepressants commonly used to treat depression and suicidal thoughts take weeks or months to begin to show positive effects. When a patient is actively suicidal, we don’t have that much time.”

McCullumsmith said patients entered in the ketamine trial at the ED are admitted to the psychiatric inpatient unit for observation.

“There is a growing body of evidence that indicates that lower doses of ketamine can reduce suicidal feelings and relieve symptoms of severe depression in a very short period of time, as little as a few hours, which makes it an extremely attractive candidate for treating acute depression."

-Richard Shelton, M.D.

“We are attempting to determine just how quickly the drug produces a beneficial result, as well as how long that result lasts,” McCullumsmith said.

Shelton said a second trial, sponsored by Janssen Research & Development, LLC., is a multi-site trial of patients with severe depression and possible suicidal thoughts who are seen in an outpatient setting. Patients receive two or three infusions of ketamine or placebo each week for four-to-six weeks. Patients who do not benefit from study treatment after the first two weeks are offered two weeks of treatment with ketamine without the chance of placebo.

“We’re interested in knowing how long each infusion will sustain the beneficial effect,” said Shelton. “Ketamine does not appear to be curative, and we have a lot of work to do to see if it might be a useful drug for depression and suicide prevention on a long-term, regular-use basis.”

Read more about depression research and watch a video on treating depression in UAB Magazine.

A third trial underway at UAB is testing a compound called Glyx-13, produced by Naurex, Inc. Glyx-13 may produce similar results as ketamine by blocking an amino acid called glycine, which works in tandem with glutamate. Glycine regulates glutamate signaling, so it is like an added layer of fine-tuning. When glycine and glutamate bind to NMDA together, the calcium ion channel opens widely. Blocking glutamate with ketamine can reduce the release of calcium. Blocking glycine with Glyx-13 may achieve the same result, but more subtly and with fewer side effects.

“Glyx-13 may prove to be a more promising candidate than ketamine in terms of potential side effects,” said Shelton. “Glyx-13 is being evaluated with just one infusion per week.”

Ketamine, when used in anesthesia, has some side effects, including hallucinations and psychotic symptoms. It has also been a drug of abuse, known on the street as Special K. Shelton said the dose used in the depression trials is much lower, and given over a longer period. Side effects observed thus far in the ketamine trials have been minimal, he said.

UAB is enrolling patients in the outpatient trials of ketamine and Glyx-13. Male and female patients ages 19-64 with a diagnosis of depression, who have failed two drug regimens for depression, are candidates for the trials. Total time involved in the studies, with treatment and follow-up, is about 13 weeks. Individuals interested in more information can contact the study coordinator at 205-975-2911 or hammond@uab.edu.

The reunion will be 11 a.m. to 3 p.m. on Saturday, April 27, 2013, at UAB’s Bartow Arena. The theme this year is Team UAB. The reunion will give former patients and their families an opportunity to reconnect with the neonatologists, nurses, respiratory therapists, social workers, chaplains and other staff who cared for them, and it gives UAB staff the opportunity to witness the fruits of their labor while they renew acquaintances with former preemies, some of whom are now adults. For information on attending the event, email kaleccia@uabmc.edu.

In addition to her contributions at UAB, Vining served as a member of Alabama’s National Guard from 1986 to 1992 and is a lieutenant in the U.S. Navy Reserves.

Lynne Vining, MSN, RN, nurse manager of the medical intensive care unit (MICU) at UAB Hospital, has been chosen as a statewide “Hospital Hero” by the Alabama Hospital Association (AlaHA) for her contributions to health care.

Vining has been a nurse at UAB Hospital since 1989, and she has been nurse manager of the MICU for two years. Under her leadership, the staff has been successful in reducing infection rates below the national benchmark and in increasing patient and family satisfaction. She is described as a mentor to many, including nursing students, medical students and residents, and she is frequently called upon to lecture at local nursing schools.

In addition to her contributions at UAB, Vining served as a member of Alabama’s National Guard from 1986 to 1992 and is a lieutenant in the U.S. Navy Reserves. For the past nine months, she served as team leader at the NATO Role 3 Hospital at Kandahar Air Field, Afghanistan. She has treated soldiers dealing with the most severe of injuries, many resulting from explosive devices.

During the April 2011 tornadoes in Alabama, her home was damaged, but true to her nature, she put her own needs aside and devoted her time to treating injured neighbors.

While all blood types are needed, the shortage of O-negative is the most severe.

The University of Alabama at Birmingham (UAB) will hold a major blood drive in February to help replenish supply following a national shortage of O-negative blood and apheresis platelets.

The drive will be held at UAB Hospital North Pavilion Feb. 18-23, 2013, and then at UAB Highlands Hospital on Feb. 26, Feb. 28 and March 1. While all blood types are needed, the shortage of O-negative is the most severe.

Eligible donors of blood or platelets can make an appointment to donate at either drive at www.givelife.org, using sponsor code “UAB,” or 1-800-RED CROSS (1-800-733-2767).

Donors will be eligible for prize giveaways. Validated parking is available at the Fourth Avenue parking deck for North Pavilion. Parking is free at UAB Highlands. Donors should bring a valid photo ID.

Nationally, UAB is one of the largest users of blood supplied by the Red Cross. Donors can give blood up to six times per year, every eight weeks.

The re-worked ambulance now has a “quad cab,” which holds an extra seat row behind the driver in the front cab. This allows the entire team of medical professionals to ride in the cab during the non-patient portion of the trip, which is safer than riding in the back.

“Providing a safer means of transport for our employees has been a priority for CCT,” said Laura Lee Demmons, CCT director. “We’ve also installed a howler siren in the unit, which gives off a strong vibration that catches the attention of even the most distracted drivers. It helps the team negotiate traffic and accomplish their mission more safely.”

The new unit, a 2006-model with a 2012 chassis designated UAB 15, is also more environmentally friendly, as it now runs on bio-diesel fuel. The re-fit took about six months at a cost of $108,000. CCT plans to re-fit a second ambulance next year.

Now in its 30th year, the CCT provides patient transfer between hospitals throughout the United States and internationally. CCT’s three ambulances performed 1,132 ground transports in 2012, as well as assisted the CCT flying intensive care unit, a modified Cessna Citation Bravo jet aircraft, with 272 air transports.

There is a critical need for O-negative blood and apheresis platelets donors.Increased demand for O-negative units and platelets in the past week has led to a shortage of these two life-saving blood products.

Eligible donors of blood or platelets can make an appointment to donate in the UAB Donor Room at www.givelife.org, sponsor code “UAB,” or call 205-996-9851. The North Pavilion Donor Room hours are 10:30 a.m. to 4 p.m., Monday through Friday.

Donors also can call 1-800-RED CROSS (1-800-733-2767) or visit redcrossblood.org today and make an appointment.

Donations will help replenish the blood supply and ensure that patients with serious medical conditions will receive the necessary blood products.

Successful donors from January 14-18 will enter a raffle for a $250 Visa card.

The room service concept kicked off in October 2010 at UAB Hospital with participation from renowned local chef Frank Stitt. Patients choose from a varied and extensive menu, and meals called in are cooked to order in the hospital kitchen and delivered within 45 minutes.

Room service is a growing trend in small or boutique hospitals. UAB officials say that, to their knowledge, UAB is the largest in the nation to go to a full-time room service approach for all patients. It remains the only Birmingham hospital to offer the complete service.

“Our goal from the beginning was to provide room service meals at Highlands, as well as at UAB Hospital,” said Jordan DeMoss, associate vice president at the hospital. “The program has been very well received, and we’re excited to now offer it to our Highlands patients.”

“The response from patients and their families has been overwhelming,” said Charlotte Beeker, director of food, nutrition and guest services. “Patients tell us they appreciate having a choice in meals, and that the food is outstanding. It’s all part of giving the patient more options and, ultimately, a better patient-centered experience.”

Beeker says patient satisfaction scores have risen to the 92nd percentile in overall meal quality since the program’s inception.

Every patient has a menu in his or her room. The patient, or a family member or hospital staffer on the patient’s behalf, can call in orders between 6:30 a.m. and 7 p.m.

“Patients order what they want to eat when they want to eat it, rather than have a food tray appear in their room on our schedule,” said Beeker.

The hotel-style room service does not add any additional costs to the patient’s stay. The hospital saw savings of more than $400,000 in the first year due to less wasted food.

The hotel-style room service does not add any additional costs to the patient’s stay. The hospital saw savings of more than $400,000 in the first year due to less wasted food.

Lunch and dinner options include soups and salads, entrée salads, deli and grilled sandwiches and numerous sides and desserts, including sugar-free offerings. Entrees include golden-crusted chicken breast, lemon baked tilapia and home-style beef pot roast and gravy, among other choices.

The menu, which was developed and tested by the Clinical Nutrition and Food Service team, also is marked to note heart-healthy menu items and the number of carbohydrates in certain offerings. The system is set up so patients or their family members will not order something inappropriate for a restricted diet.

“The room service model is a good patient-education tool,” said DeMoss. “It helps patients learn about good nutrition, healthy diets and portion control as they enjoy some of their favorite meals while in the hospital.”

An added treat continues to be menu items developed by renowned local chef Frank Stitt, a James Beard-award winner. Stitt designs three menu items that rotate quarterly on the menu. UAB chefs prepare the items under Stitt’s tutelage, using ingredients purchased from the same vendors Stitt uses in his restaurants.

“I think good, healthy food can help nourish, restore and rejuvenate people who are in the hospital,” said Stitt. “Hospitals are about getting better, and good food can be a big part of healing.”

In a review article published in the Clinical Therapeutics section of the Dec. 27, 2012, issue of the New England Journal of Medicine, a University of Alabama at Birmingham (UAB) nephrologist and internationally known expert on continuous renal-replacement therapy (CRRT) explains why performing dialysis on intensive care unit (ICU) patients with kidney failure, slowly over a 24-hour period as compared to standard dialysis techniques, provides better hemodynamic stability and fluid removal.

“It’s a therapy with which many physicians are not familiar, which is why the New England Journal invited me to write the article,” said Ashita Tolwani, M.D., professor of medicine in the Division of Nephrology.

Tolwani said patients in the ICU often develop kidney failure from multiple causes, including severe infection, low blood pressure and medications. The mortality rate for critically ill patients with acute kidney failure is greater than 60 percent. Because these patients are so unstable, they do not tolerate regular dialysis procedures well, which can lead to cardiac arrest.

“CRRT is far gentler than regular dialysis,” Tolwani said. “It runs 24 hours a day, continuously removing fluids, solutes and toxins the kidneys build up. It is the preferred type of dialysis treatment for these critically ill patients, because it allows physicians to give patients whatever fluids, nutrition, antibiotics or other medications they need without worrying about the accumulation of waste products and fluid from the failing kidneys.”

UAB Hospital logs more than 5,000 patient-days per year with the therapy.

Because CRRT is a complicated therapy, more so than regular dialysis, it is only available at hospitals that have the expertise to provide it. It requires specialized physician knowledge and special training for nurses. To make the therapy run 24 hours, it requires special anticoagulants. Tolwani has patented one such anticoagulant used in CRRT.

UAB Hospital logs more than 5,000 patient-days per year with the therapy.

“We have one of the largest CRRT programs in the U.S.,” Tolwani said. “We have 25 CRRT devices and run 10-15 devices a day. Most other places have fewer than 10 CRRT devices.”

Tolwani hopes that by increasing knowledge of the procedure in the medical community, more patients will be treated effectively.

“The review article is for clinicians to understand more about the therapy, its indications and advantages, the evidence for it, its side effects, the process by which it’s done and the physiology behind it,” she said.

To this end, the UAB Division of Nephrology and UAB Hospital Nursing each year host a two-day training symposium on CRRT for clinicians, nurses and pharmacists. The next session will be held in September 2013. It will incorporate one day of didactics and one day of simulation training using UAB’s simulation center.

“In-depth practical training for CRRT is not widely available, so we provide the annual symposium for those who do not have access to such training at their institutions,” Tolwani said.

Because blood supplies are often low during and after the holidays, as usual donation patterns are altered by holiday travel and activities, the University of Alabama at Birmingham (UAB) and the American Red Cross are hosting a special blood drive. The holiday drive begins on Monday, Dec. 10, at the UAB North Pavilion and ends at UAB Highlands Hospital on Dec. 20.

Donors will be eligible for prize giveaways, including a DVD player and other electronic devices, as well as $10 gift certificates to UAB-area businesses. Validated parking is available at the Fourth Avenue parking deck for the North Pavilion drive. Parking is free at UAB Highlands. Donors should bring a photo ID.

The UAB/Red Cross drive is on the second-floor atrium of the UAB North Pavilion, 18th St. and 6th Ave., on Monday, Dec. 10, through Saturday, Dec. 15. It moves to UAB Highlands Hospital, 1201 11th Ave. South, from Tuesday, Dec. 18, through Thursday, Dec. 20.

Nationally, UAB is one of the largest users of blood supplied by the Red Cross. Donors can give blood up to six times a year, every eight weeks. The overall process takes about 45 minutes; blood collection usually takes less than 20 minutes.

Blood products are used during surgery, transplantation, trauma care, difficult pregnancies and cancer treatment. It is not unheard of for a single patient to require as many as 100 units.

UAB Medicine is dedicated to serving as a role model for good health behaviors and will no longer hire tobacco users as of July 1, 2013.

As a world-class medical center, UAB Medicine is dedicated to the preservation of health and prevention of disease. In order to provide the best care and support to patients, UAB Medicine employees must be in the best health possible. For that reason, UAB Medicine is launching a tobacco-free hiring policy for all new hires on or after July 1, 2013.

“Tobacco use is a major cause of illness and death in our state,” says UAB Health System CEO Will Ferniany, Ph.D. “For more than 100 years, UAB Medicine has been dedicated to preserving health and preventing diseases in Birmingham and beyond. As health-care providers, UAB Medicine and the entities that comprise it should be role models for good health behaviors, and lead by example in the quest for good health. We believe one of the best ways to accomplish this is to encourage people to stop using tobacco products and, in anticipation of the 37th Great American Smokeout tomorrow, we are announcing our new hiring policy.”

The policy will extend to anyone applying for a UAB Medicine job after July 1, 2013 — this includes jobs with the UAB Health System, UAB Hospital, University of Alabama Health Services Foundation, The Kirklin Clinic, The Kirklin Clinic at Acton Road, UAB Callahan Eye Hospital, University of Alabama Ophthalmology Services Foundation, Triton Health Systems L.L.C./VIVA Health Inc. and Birmingham-area UAB Health Centers. The policy does not apply to the University of Alabama at Birmingham as a whole.

According to the new policy, tobacco use includes smoking, sucking/dipping, chewing or snuffing any tobacco product. Prospective employees will be tested for nicotine use as part of their pre-employment drug screening following a job offer. Those who test positive for nicotine use will not be hired.

“We care deeply for all members, and prospective members, of the UAB Medicine family, and as health-care providers we wanted to take a major step toward providing a healthier environment for employees, patients and hospital visitors,” Ferniany says. “Our intent is not to eliminate people from applying for positions with UAB Medicine, but rather to send the message that as the largest health-care provider in the state, we are committed to the health of our employees and all Alabamians.”

Each year in Alabama, 7,500 people die from tobacco-related illnesses and more than 800 non-smokers die from illnesses related to secondhand smoke, according to the Alabama Department of Public Health. More than 20 percent of Alabamians smoke and nearly 10 percent use smokeless tobacco.

The policy does not apply to current UAB Medicine employees or individuals hired prior to July 1, 2013 who smoke or use other forms of tobacco. For current employees, UAB Medicine is ramping up efforts to provide smoking and tobacco-cessation programs to help them achieve their best possible health.

“Our employees are the most valuable asset UAB Medicine has and their health and that of their families is very important to us,” Ferniany says. “Knowing that tomorrow is the Great American Smokeout, we are encouraging current members of the UAB Medicine family to take advantage of the many programs and services, including smoking-cessation classes, which we provide. They can visit the UAB Employee Wellness website for more details on all of these services.”

UAB Medicine is not the first health-care organization to adopt this type of policy. Hospitals and health systems in Florida, Georgia, Massachusetts, Missouri, Ohio, Tennessee and Texas also have stopped hiring people who use tobacco, according to the Society for Human Resource Management. This includes several nationally ranked health-care providers, such as theBaylor Health Care System, whose policy went into effect earlier this year, and Cleveland Clinic, which has had a tobacco-free hiring policy since 2007.

Hospital Maintenance will support UAB's Child Life Program for the 31st consecutive year this Christmas, and the group is requesting your help to support hospitalized children through the form of donations.

UAB’s Child Life Program, which was featured in the UAB Reporter in Dec. 2011, provides children and their families comfort in times of need and memories in times of turmoil.

Donations can be sent to Hospital Maintenance, 619 19th Street South, Room S036, Birmingham, AL 35294. Make all tax deductible checks payable to the UAB Pediatrics Toy Fund on or before Dec. 10.

Everyone also is invited to the annual Christmas Toy Fund Celebration, scheduled for 10 a.m. to noon Thursday, Dec. 20 in North Pavilion.

In what NRC calls “the nation’s most comprehensive consumer assessment of the health-care industry,” consumers named 3,200 hospitals in 190 markets throughout the contiguous United States. The annual survey represented 400,000 consumers in 200,000 households. The categories in which hospitals were evaluated include Best Overall Quality, Best Image/Reputation, Best Doctors and Best Nurses.

“We are honored to receive the Consumer Choice Award again, especially as this award comes directly from the people whom we serve,” says Michael R. Waldrum, M.D., chief executive officer of UAB Hospital. “Our goal at UAB Hospital is to provide the highest quality of care possible to our patients and their families. Recognition such as this is a good barometer of our success and motivation for all of us to continue to provide the very best medical care.”

The newest and largest hyperbaric chambers in Birmingham are now open at the UAB Wound Care and Hyperbaric Medicine Program.

The two newest hyperbaric oxygen chambers in Birmingham are up and running in the new Wound Care and Hyperbaric Medicine Program clinic at UAB Hospital. The clinic, which formally opened on Aug. 27, 2012, provides hyperbaric treatment for chronic wounds that won’t heal or for infected acute wounds following surgical procedures. It is the only hyperbaric chamber facility in Birmingham to offer around-the-clock emergency care.

Hyperbaric chambers increase the pressure around a patient while they breath, causing more oxygen saturation in the bloodstream. They have long been used for treating decompression injuries, known as “the bends,” in deep-sea divers.

Oxygen saturation is also a catalyst in wound healing and hyperbaric chambers are used in a variety of medical situations. Chronic wounds that resist healing, often related to vascular insufficiency or diabetes, are the most common application. The chambers are also used to treat acute carbon dioxide poisoning, and air or gas embolisms, which can occur during surgery or other medical procedures. Radiation-damaged tissue, burns and trauma patients, as well as those with vascular disease, may also be treated in hyperbaric chambers.

“We typically see chronic wounds, especially in the feet or lower leg, in patients with poor circulation or diabetes,” says Keith Knight, manager of the UAB wound care program. “Wounds must have sufficient oxygen to heal, as it promotes new tissue growth and angiogenesis, the process of growing new blood vessels in damaged tissue.”

The new Wound Care and Hyperbaric Medicine Program clinic at UAB Hospital provides hyperbaric treatment for chronic wounds that won’t heal or for infected acute wounds following surgical procedures. It is the only hyperbaric chamber facility in Birmingham to offer around-the-clock emergency care.

During treatment, the patient simply lies down in the chamber while the pressure is increased up to three atmospheres. Patients can communicate with technicians via an intercom system, watch TV or sleep while undergoing treatment.

Treatment for chronic wounds typically consists of multiple treatments (up to 30 or more) for two hours at a time, five days a week. A single treatment is usually sufficient for some acute problems such as decompression sickness and air or gas embolism.

]]>bshep@uab.edu (Bob Shepard)Focus on Patient CareFri, 07 Sep 2012 09:17:51 -0500UAB Health System among the most wired in the nationhttps://www.uab.edu/news/focus-on-patient-care/item/2644-uab-health-system-among-the-most-wired-in-the-nation
https://www.uab.edu/news/focus-on-patient-care/item/2644-uab-health-system-among-the-most-wired-in-the-nation

The UAB Health System again is noted for its use of information technology to improve health care.

This is the 10th year the UAB Health System has been included in the most-wired listing; 1,570 hospitals, or roughly 27 percent of all U.S. hospitals, were included in the survey.

Hospitals are surveyed on their use of Internet technologies in four core areas; infrastructure, business and administrative management, clinical quality and safety and clinical integration. Hospitals must meet standards in all four areas to achieve the most wired designation.

In comparing hospitals and health systems across the country, HHN found that the most-wired hospitals:

Use computers to enable physicians to check or order patient tests.

Enter medications orders electronically.

Enable patients to perform billing functions via computer.

Conduct more pre- and post-implementation evaluations of IT projects.

Maintain a larger proportion of their medical records in a paperless format.

Provide digital imaging to more clinical disciplines in a wider range of settings.

Employ a broader set of telemedicine services.

Deploy more IT educational resources for staff.

“This continued recognition of the UAB Health System as ‘Most Wired,’ by HNN reflects our strong commitment to information technology as a strategic imperative.”

“This continued recognition of the UAB Health System as ‘Most Wired,’ by HNN reflects our strong commitment to information technology as a strategic imperative,” said Joan C. Hicks, UABHS chief information officer. “I am so proud of the HSIS staff for their exemplary work effort to achieve this recognition.”

At UABHS, physicians are able to manage a number of clinical functions online, including checking laboratory and imaging results, reviewing clinical notes from other health-care providers and entering patient-care notes and medication orders.

UAB Hospital will work towards international "Baby-Friendly" designation.

UAB Hospital is the only hospital in Central and North Alabama, and one of three in the state, selected to participate in Best Fed Beginnings, a new national effort to significantly improve breast-feeding rates in states in which they are the lowest.

Although breast-feeding is one of the most effective preventive health measures for infants and mothers, half of babies born in the United States are given formula within the first week, and by age 9 months only 31 percent of babies are breast-fed.

According to the 2012 Centers for Disease Control and Prevention “Breastfeeding Report Card”, the rate for breast-feeding newborns in the United States was 76.9 percent — Alabama’s was 57.2 percent. Fewer than 25 percent of babies in Alabama are breast-fed at six months, and only 8 percent continue breast-feeding at one year, compared with 29.7 percent nationwide. Alabama is ahead of only Louisiana, Mississippi and West Virginia in breast-feeding rates.

Best Fed Beginnings seeks to reverse these trends by increasing the number of U.S. hospitals implementing a proven maternity services model that best supports a new mother’s choice to breast-feed. The National Initiative for Children’s Healthcare Quality is leading the effort through a cooperative funding agreement with the CDC and will be working closely with Baby-Friendly USA Inc. and selected hospitals to implement the initiative.

The American Academy of Pediatrics recommends babies be breast-fed exclusively for the first six months of life.

This designation verifies that a hospital has comprehensively implemented the WHO/UNICEF Baby-Friendly Hospital Initiative, which recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother-baby bonding. Breast-feeding rates are higher and disparities in these rates are virtually eliminated in hospitals that achieve this status.

The American Academy of Pediatrics, which has endorsed Ten Steps to Successful Breastfeeding outlined in the WHO/UNICEF Baby-Friendly Hospital Initiative, recommends babies be breast-fed exclusively for the first six months of life followed by continued breast-feeding as complementary foods are introduced, with continuation of breast-feeding for one year or longer as mutually desired by mother and infant.

Rune Toms, M.D., medical director of the UAB Regional Neonatal Intensive Care Unit and chair of the Alabama Breastfeeding Coalition education committee, says breast-feeding is important for the health of both mothers and babies. Breast milk provides optimal nutrition for babies, with a perfect concentration of carbohydrates, proteins, fats, minerals, vitamins and hormones. Breast milk also protects babies against infections and the mother provides valuable antibodies and other factors that help babies develop their own immune systems. For mothers, breast-feeding is associated with lower maternal risks of breast and ovarian cancer, Type 2 diabetes and postpartum depression. It also can be a great way to lose extra weight gained during the pregnancy.

For UAB’s patients and employees, breast-feeding has been a priority at the university, Toms says – even before this opportunity presented itself.

“UAB is a huge advocate in encouraging breast-feeding,” Toms says. "We already employ most of the steps set forth by the WHO/UNICEF Baby Friendly Hospital guidelines. We have a written policy supportive of breast-feeding, and our goal is to feed term babies breast milk within the first hour of life. Further, we provide private areas within the hospital and around campus where mothers can feel comfortable breast-feeding. We also provide full support from our staff — all of our nurses are certified breast-feeding educators — and we have internationally board-certified lactation consultants on staff to support for nursing mothers."

In addition, August is National Breastfeeding Awareness Month, and as part of its kickoff for the Best Fed Beginning initiative UAB is hosting discussions with health-care providers and patients to identify preferred ways to educate mothers about infant feedings. Knowing the best ways to approach and teach expectant and new parents about the importance of breast-feeding is one of the keys to increasing the number of breast-fed babies.

“The UAB Innovation Board’s funding of our infant-feeding focus groups is a reflection of the commitment UAB has to reaching out to the community to identify and meet our patients’ needs in creative ways,” Edwards says. “The community focus groups are a collaborative effort engaging partners from the various UAB Obstetrics and Gynecology clinics, UAB School of Health Professions, Jefferson County WIC Office and Healthy Start.

Bottom line, Toms says, is that breast-feeding is fundamental to good health, but too often is dismissed.

“We need more education programs at birth facilities and in community health services. There need to be more community nurses and lactation consultants available in these settings to help nursing mothers. There also need to be more community breast-feeding groups created to provide nursing mothers peers to assist and support them,” Toms says. “And, there needs to be acceptance of breast-feeding breaks in the workplace and private locations in workplaces and in public places to accommodate breast-feeding mothers. When these things are accomplished, I believe the number of women breast-feeding their children at least six months will grow.”

New minimally invasive procedure to replace damaged aortic valves can help patients for whom open surgery is not an option.

The University of Alabama at Birmingham Hospital is the first facility in Alabama to offer a new minimally invasive procedure for replacing heart valves in people with aortic stenosis who are not candidates for an open procedure.

UAB interventional cardiologists Massoud Leesar, M.D., (far left) and Mark Sasse, M.D., (center) and cardiothoracic surgeon James Davies, M.D., (far right), along with UAB TAVR team members and representatives from Edwards Lifesciences, go over a mock procedure to prepare for UAB’s first TAVR case in early August.

UAB cardiothoracic surgeon James E. Davies, Jr., M.D., assistant professor in the UAB Division of Cardiothoracic Surgery, says the team is on schedule to perform its first surgery in early August.

“Given the fact that we perform more valve procedures overall than anyone in the state — and have since the inception of our program – we are excited to be home to Alabama’s most comprehensive valve clinical and surgical treatment program and to be the first to offer this unique, life-saving procedure to the people of Alabama and surrounding states,” Davies says.

UAB Heart and Vascular Services is home to the state’s largest and oldest heart valve disease treatment program.

According to the American Heart Association, nearly 1.5 million people in the United States suffer from severe hardening or narrowing of their aortic valve — known as aortic stenosis — and approximately 500,000 suffer from a severe form of the disease. It is estimated that 250,000 of these patients suffer from symptoms, which include severe shortness of breath, extreme fatigue, chest pain and fainting.

In elderly patients, severe, symptomatic aortic stenosis is often caused by the build-up of calcium on the flaps of tissue that open and close the aortic valve, impairing its ability to regulate the flow of blood through the aortic valve. As a result, the narrowed valve allows less oxygen-rich blood to flow from the lungs to the brain and the rest of the body.

Davies says current American College of Cardiology/American Heart Association guidelines recommend treating virtually all patients with severe, symptomatic aortic stenosis with surgical aortic valve replacement and that open-heart aortic valve-replacement surgery is the gold standard. However, there are patients who are not candidates for open surgery – basically open heart surgery requiring bypass – because of age, history of heart disease, frailty or other health issues. But, without replacement of the aortic valve, the disease is life-threatening.

“Patients who have severe aortic stenosis have a 50 percent chance of dying within one-and-a-half to two years after the onset of symptoms without treatment,” Davies says.

Edwards SAPIEN transcatheter heart-valve replacement was approved by the U.S. Food and Drug Administration in November 2011. It has been designed specifically for patients suffering from severe, symptomatic aortic valve stenosis for whom open-heart aortic valve-replacement surgery is too risky. Instead, the balloon-expandable SAPIEN valve is inserted via a catheter through a small cut in the thigh into the femoral artery. The physician then threads the catheter up to the heart and puts the valve into place. In all, the procedure takes from two to four hours. The average hospital stay is two to four days, and recovery time is one to two weeks.

“Approximately 30 percent of patients with aortic stenosis are unable to have the traditional surgery, and until recently the prognosis for those patients was poor,” says Massoud A. Leesar, M.D., professor and section chief of UAB Interventional Cardiology. “For these patients, this procedure adds years to their lives and life to their years. Patients who undergo this therapy experience a much higher quality of life.”

UAB’s TAVR program got off the ground in May 2012 when Heart and Vascular Services expanded its valve clinic offerings to treat patients with end-stage aortic valve disease. In this clinic, patients undergo a comprehensive evaluation by a multi-disciplinary team of specialists, including cardiologists and cardiac surgeons, to determine whether TAVR is an appropriate option. In some cases, Leesar cautions, it may not be an option because co-existing medical conditions would prevent the patient from experiencing the expected benefits or because the risks outweigh the benefits. Also, many patients referred for the TAVR procedure may be deemed a candidate for standard aortic valve replacement.

In addition to offering TAVR, the UAB Comprehensive Valve Program — which includes a multidisciplinary team of interventional cardiologists, cardiac surgeons and expert staff — provides aortic and mitral valve treatment, offering interventional and surgical treatment options including valvuloplasty, valve-replacement surgery, robotic valve repair, valve-sparing aortic root replacement and the Ross Procedure. In addition, the program is the most equipped and experienced facility in the state for treating and managing adults with congenital valve disease, Davies says.

UAB and the Red Cross are holding a blood drive the week of July 9-14.

The blood supply nationwide is low, a frequent occurrence in the summer months. Disruptions in regular collection patterns has left the Alabama blood supply at below optimum levels, say blood supply officials at the University of Alabama at Birmingham and the American Red Cross.

UAB and the Red Cross are holding a blood drive the week of July 9-14 at the UAB Hospital North Pavilion, second floor atrium. A drive is also scheduled for UAB Highlands Hospital on Wednesday, July 18 and Thursday, July 19. All blood types are needed.

Drive hours at the North Pavilion, 18th Street and 6th Ave. North, are:

Monday, July 9, 10 a.m. - 5 p.m.

Tuesday, July 10, 10 a.m. – 5 p.m.

Wednesday, July 11, 10 a.m. – 5 p.m.

Thursday, July 12, 12 a.m. – 5 p.m.

Friday, July 13, 7 a.m. – 2 p.m.

Saturday, July 14, 10 a.m. – 5 p.m.

Hours at UAB Highlands, 1201 11th Ave. South:

Wednesday, July 18, 11 a.m. – 5 p.m.

Thursday, July 19, 6:30 a.m. – 12:30 p.m.

Donors should bring a photo ID. Free parking is available in the North Pavilion parking deck.

UAB is one of the largest users of blood nationally supplied by the Red Cross. Donors can give blood up to six times a year, every eight weeks. The overall process takes about 45 minutes. The actual blood collection usually takes less than 20 minutes.

Blood products are used during surgery, transplantation, trauma care, difficult pregnancies and cancer treatment. It is not unheard of for a single patient to require as many as 100 units.

]]>bshep@uab.edu (Bob Shepard)Service to CommunityMon, 09 Jul 2012 13:51:23 -0500UAB is first in Alabama to use the Melody Valve to repair heart defectshttps://www.uab.edu/news/focus-on-patient-care/item/2135-uab-is-first-in-alabama-to-use-the-melody-valve-to-repair-heart-defects
https://www.uab.edu/news/focus-on-patient-care/item/2135-uab-is-first-in-alabama-to-use-the-melody-valve-to-repair-heart-defects

The new procedure means some patients with congenital heart defects can avoid open heart surgery.

In many ways Dylan Fields is your typical 15-year-old boy. He loves sports, and plays baseball and soccer for his school, Tallassee High, in Central Alabama. What’s not typical about Dylan is his heart defect and, now, the procedure used to repair his heart.

In early February, Dylan received a procedure now being performed at UAB Hospital, a Melody Valve replacement – a pulmonary valve inserted through a catheter. UAB is the first hospital in Alabama to use this new technique, which replaces open-heart surgery. This means Dylan, and others like him, likely will have fewer surgeries than they may have faced a few years ago.

When Dylan came into the world Jan. 29, 1997, he was diagnosed with tetralogy of Fallot,a congenital heart defect involving four abnormalities — including an obstruction of blood flow from his heart to his lungs, a hole between the two bottom chambers of his heart, a misplaced aorta and enlargement of his heart’s right ventricle.

At 6-weeks-old, Dylan had his first open-heart surgery to repair the hole, called a ventricular septal defect, and correct a pulmonary valve obstruction.

When he was 5, Dylan’s mother, Dana Fields, says he became so tired “he didn’t want to eat.” Doctors decided he needed a new pulmonary valve, so during a second open-heart surgery they inserted one from an organ donor, but the experience was initially very taxing.

“He was on the ventilator overnight. He was crying. He had all of this stuff attached to him, and it was hard,” his mom says.

Despite that rough night in intensive care, Dylan made a complete recovery as a typical active little boy — thriving, going to school, playing with his friends and family. Fast-forward 10 years and Dylan, a budding high-school soccer player, started feeling tired again.

“I got short of breath a lot,” Dylan said. “I play mid-field, and it felt pretty bad. I would get out of breath the first two laps.”

“He would go to bed at night and wake up the next morning like he hadn’t even been asleep,” Fields says. “He was pale. He was getting where he couldn’t stay and hang with the other kids his age.”

Fields brought Dylan in to see his cardiologists at UAB -- the replacement valve he received 10 years earlier was failing.

“Dylan had an enlarged right ventricle because of his valve abnormality,” says UAB pediatric cardiologist William McMahon, M.D. “The valve that was replaced when he was 5 no longer worked very well and leaked. When surgeons replace a pulmonary valve, we hope that it is going to last 15 to 20 years. But often dysfunction occurs earlier than that because it becomes blocked or leaks. Dylan developed a substantial amount of leakage, and the pulmonary valve needed to be replaced.”

Until recently, replacing someone’s pulmonary valve required open-heart surgery. But McMahon offered the Fields another option — using the minimally invasive Melody Valve procedure to repair Dylan’s faulty pulmonary valve. The Melody Valve is a newly designed device with a valve mounted inside a stent. The stent is mounted on a balloon catheter and delivered from a small incision in the patient’s groin up into their heart.

McMahon says the Melody Valve is used in a fairly small subset of patients — ones born with congenital heart disease who already have had a pulmonary valve-replacement operation. The procedure, he says, can be a better alternative for patients who need multiple operations to replace the pulmonary valve.

“To some extent each new operation carries additional risk — each time you open the chest cavity and each time a patient goes on cardiac bypass,” he says. “If we can reduce the total number of operations Dylan is going to need in his lifetime by two – by replacing the pulmonary valve with a Melody Valve then in this case – I consider this a better alternative to an open procedure.”

So far, Fields says she is very happy with the Melody Valve and is pleased with the outcome.

“I’m glad we did it,” Fields says. “Unlike when he was younger, I was actually able to see him as soon as he got out (of surgery), and I was able to be in the recovery room with him. It was a lot better. And one of the things I noticed about him was that he had color in his lips and cheeks; they were real pink, and he wasn’t as pale. ”

“In general a recovery time of two to three days for a procedure such as this is expected, then back to full activity,” he says. “This is compared to four to six weeks for open-heart surgery.”

Dylan, who was able to go back to school about a week after getting his new valve, agrees and says he hopes he will get to play baseball this season.

“Dr. McMahon said that we will talk about it,” he says.

Fields is optimistic.

“We will discuss it more in a couple of weeks but the chances are better than with open heart surgery,” she added. “With open heart there would be no way.”

McMahon, too, is optimistic. He feels good about how long Dylan can go without another open procedure.

“The idea behind the Melody Valve transcatheter therapy is to extend the life of the previously placed surgical valve,” he says. “We did not replace the need for another operation. We know it’s likely Dylan will need another operation to replace this pulmonary valve in the future. But, in Europe where the Melody Valve has been used for five or six years longer than in the United States, more than half the patients go more than five years after Melody Valve implantation before needing surgery. And, some patients are approaching 10 years.”

UAB Medicine has named Dennis Stanek its Emergency Management Director.

Dennis Stanek, previous UAB Hospital Safety Manager, was recently named UAB Medicine Emergency Management Director. In his new role, Stanek carries out preparedness activities at the UAB Medicine level, including coordinating the development and maintenance of emergency response plans for each medicine entity.

This is a new position developed as a result of UAB’s emergency management organizational effectiveness initiative. Stanek, a UAB Hospital employee since 1995, has more than 22 years of experience supervising environment-of-care and emergency management programs. His primary focus areas are University Hospital, The Kirklin Clinic, Callahan Eye Foundation Hospital and Health System employees.

Stanek serves as the primary point of contact for UAB Health System executives and coordinates the use of emergency support functions. He works with all emergency management teams to facilitate communication and coordination to continue to provide the best possible care and treatment of patients in the event of an emergency.

Tornado survivor Penny Anthony battles through rehab with the goal of returning to her career — as a rehab therapist.

Penny Anthony likes her job. She is a certified occupational therapist assistant at the University of Alabama at Birmingham’s Spain Rehabilitation Center. For the past 11 years she’s enjoyed helping people rebuild their lives if accident or disease left them disabled. But in November 2011, everything changed when she became a patient.

Penny was in her home in Pleasant Grove, Ala., on April 27, 2011, because a morning storm had dropped a tree branch on her house. She stayed to contact the insurer and ensure the roof didn’t leak. She has no memory of the massive tornado that roared through Pleasant Grove that afternoon and destroyed her house. Rescuers later told her they found her a block and a half away.

“I had a traumatic brain injury. Something hit me across my face and tore my scalp back, almost amputating my left ear,” she recalled as she ran through the litany of injuries. “I had a spinal-cord injury and breaks in the pinky finger of my left hand. My left leg had a tibia plateau injury (an injury at the end of the bone), and I had a lung injury and other lacerations on my body.”

After five weeks in intensive care at UAB Hospital and months more recovering at her brother’s house, she returned to Spain for outpatient rehabilitation in November. Her friends and co-workers now were her therapists.

“I’m supposed to be helping the injured patient; I’m not supposed to be the injured patient,” she said about coming to terms with her new role. “It’s opened my eyes to the rehab patient’s point of view.”

Her goal is to return to her old job, but more rehab and additional surgeries await her. Physical therapist Brian King says she will have a unique perspective when she does return.

“She’s seen rehab from the other side,” said King. “It's a view that most of us never see. I think when she comes back, she’s really going to understand the patients’ needs.”

Penny has many reasons to be thankful. Friends and family have eased her journey, and her dog P-nut — also in the house when the twister struck — was found safe the next day. P-nut is staying with friends until Penny is able to care for her in what she hopes is a new home.

“My plan is to rebuild on my land in Pleasant Grove,” she said. “A group of architects and builders have joined to offer their services free in the tornado-damaged communities.”

Rebuilding won’t be easy. Insurance won’t cover everything, and she’s received no assistance from the federal government. She’s hoping that with some help here, a gallon of paint there, she’ll be able to see construction begin this month.

“It’s been a hard journey, but it’s been an awesome one,” she said. “I believe and have faith that I will continue to be blessed so that one day I can once again switch roles and be a therapist again. I believe I can better understand and better help people on the same journey that I have been on.”

From decorating a patient’s room to arranging for music or massage therapy, UAB experts offer tips to bring the holidays to the hospital.

There are few holiday presents worse than a hospital stay. But if a loved one or friend must be hospitalized this season, University of Alabama at Birmingham experts say you can take steps to ensure their holiday is still merry and bright.

“Being in the hospital can be distressing for anybody,” says Joshua Klapow, Ph.D., a UAB clinical psychologist. “While the psychological impact may be short-lived, the bottom line is people would rather be well and home than sick and away.

“The holidays are about social interactions, the sharing of emotions and connecting as humans, and there is nothing written that says this cannot occur in a hospital setting. Bring the holidays to the hospital,” Klapow explains.

How to do that, you ask?

“In addition to the hospital’s efforts to enhance the holiday spirit of our patients, like providing music therapy and collecting toys and stockings for the children, family and friends can also take part in a variety of ways,” explains Jordan DeMoss, assistant vice president of UAB Hospital.

First and foremost, visit and spend time with your loved one.

“The simple presence of familiar faces is sometimes all the comfort a patient needs while in the hospital,” DeMoss says.

Provided they are in a non-intensive care setting, DeMoss offers these tips for sharing holidays in the hospital:

Bring decorations like lights and stockings to their room when you visit.

If dietary rules allow, bring in your loved one’s favorite food or tell a nurse about their favorite holiday meal; the hospital chef might be able to prepare something special.

Ask care providers if a massage is safe for the patient; if so, arrange for a licensed massage therapist to deliver a “house call” to your loved one in the hospital.

Inquire about in-room music therapy or bring in a stereo and play favorite holiday tunes.

Engaging in familiar activities – anything from knitting to video games – can help divert a patient’s mind from unfamiliar surroundings and bring a sense of routine and happiness.

If you can’t physically visit the hospital, DeMoss says to use technology to your advantage.

“Most hospitals have free Wi-Fi access throughout and Skype is a free and easy way to connect with loved ones who are far away,” DeMoss says.

“Last year I told my daughter about a patient on our floor who had no family or friends to visit him. She brought a Christmas tree to his room,” Middlebrooks says. “Soon enough, the whole staff was participating and bringing him presents and other goodies.”

Whether it’s a friend, family member or a stranger, Klapow says to be sure the patient knows you’re there by choice, they aren’t ruining your holiday.

“Convey to them that you are celebrating that they are here with you. Focus on the meaning of the holiday, and not so much the environment,” he says.

We all know the songs, so why not sing along? Singing and listening to music can improve the holidays for everyone, young to old.

You’ve probably heard a holiday song today, or perhaps you even hummed one to yourself. This time of year, it’s hard to get away from them. They’re even on ring tones.

Whether you find it uplifting or annoying, there’s good reason to join in the caroling, says Casey Brasher, a board-certified music therapist at the University of Alabama at Birmingham. Singing, and even listening to music, is good for your body and your mind, and it is something everyone in the family, from youngest to oldest, can do together – perfect pitch not required.

“Music is so beneficial to so many different populations and ages, in so many different ways,” Brasher says. “Music can take us to different places.” For people dealing with pain or anxiety, not uncommon during the holidays, music can be especially helpful for distraction to a heap of holiday chores, or relaxation while circling the parking lot again and again.

“When you are singing, you have to take a deeper breath,” Brasher says. “That extra oxygen can really help people calm down.” It can lower a person’s heart rate as well, she says. Just like taking a deep sigh, it has a relaxing effect on the body.

In a clinical setting, music therapists use patient-preferred music, and cater to the needs of patients by using their favorite music to help achieve physical goals. Many patients begin asking as early as October for Christmas music because it is tied to so many special memories and they want to feel all the emotions that go with those good memories, she says.

“A lot of time patients who may have Alzheimer’s or dementia may not be able to remember who their family members are, or where they are, or even who they are sometimes, but they can sing a familiar song and Christmas songs are familiar,” Brasher says.

But anyone can benefit from an occasional “fa la la,” and Brasher offers these tips to use music as a holiday stress reliever:

Take a moment for yourself in a quiet place and play a song that you find soothing. “Listen to the lyrics, maybe sing along and take some deep breaths. Relaxation is important.”

If you or your family is in crisis during the holidays, singing can help normalize the situation. “It’s something that everyone knows and everyone can enjoy, and it can take an awkward or uncomfortable situation and make it more comfortable.”

To enjoy music with your family, come together in one place without distraction. Sing songs that are familiar to everyone.

For people who are experiencing health difficulties, singing can increase muscle strength in the neck and back of the tongue, and by breathing more deeply, patients can increase their lung capacity, which helps them take bigger breaths and increases oxygenation to the body. Patients who have had a stroke or other trauma and can’t speak often can sing, because music is processed in a different part of the brain.

Brasher says you don’t necessarily have to sing to reap the benefits of music.

One example music therapists see is when they play music for premature infants. “When they listen to music, their oxygen saturation can actually improve; we can see it on the monitors,” Brasher says. “Sometimes nurses have to turn down their supplemental oxygen, because their blood is oxygenated when they hear that music. That can be true for patients who are in the ICU, too. That stimulation, hearing the music, can improve vital signs.”

So while singing holiday songs might not part the teeming traffic waters at the mall or deliver that last-minute gift idea on time, the physiological benefits just might help you survive the season with a little more jolly and a little less folly.

Wilkins works as a patient care assistant in UAB’s Emergency Department. As she talked to the woman, her mind filled with her own memories of loss. The 24-year-old Florence native’s father died of congestive heart failure during her junior year in high school; then, her mother passed away during her junior year in college. As an only child, the loss was almost too great, she says.

Carrying a full load as a double major in biology and psychology, Wilkins considered taking a break from college – at least temporarily. But UAB faculty, staff and students embraced her and helped her complete her educational journey, she says. On Saturday, Dec. 17, 2011, she will receive her undergraduate degree with plans of remaining at UAB and enrolling in the Surgical Physician Assistant program.

“UAB became a place of safety,” she says. “I feel like I owe a lot to the school.”

On that night in the ED, Wilkins gladly returned the favor to the widow. “If anything good comes out of this it is that I don’t have empathy for people anymore,” she says. “It’s more than that; I have heartfelt compassion for them.”

“Stephanie has that spark inside that keeps her going even through adversity,” says Nate Wade, academic advisor in the UAB Department of Biology. The university offers an assortment of personal and academic counseling services for students who experience hardship during their college career. Many, Wade says, find it difficult to recover and struggle to finish college.

Wilkins came to UAB on the heels of having lost her beloved dad. She remembers how he loved singing the blues while driving in his car, going on walks, taking picnics and dancing with his daughter. His death was unexpected.

“All of a sudden it was over,” she says.

Wilkins entered UAB having lived her whole life in a small town. She went to school with the same 50 students from kindergarten up. They all looked alike, worshipped alike and came from the same socio-economic background. Coming to UAB, with its diverse population, was like entering a different world, she says.

Wilkins remembers the day she moved into Blazer Hall. Feeling a bit overwhelmed, she looked out the window and called out to her mom and said, “You’re coming back to get me, right?”

“I was this little fish in the huge group of people,” she says.

But that’s what her parents wanted, she says. They wanted her to be exposed to diversity, get a good education and feel as if she were among a world of siblings.

“I learned more my freshman year than I have learned my entire life,” she says, musing about the first time she made spring rolls and joining Alpha Gamma Delta sorority where she met “some of my greatest friends.”

During the next few years, Wilkins’s mother was her rock. She was the one she called when she had an exam or just wanted to chat. Her mother would give her advice on all sorts of things, including how not to act awkward when a guy tries to hold your hand.

Then, in 2009, her mother died suddenly from complications of hepatitis C.

“Getting out of bed was the hardest thing for me to do,” Wilkins says. “Initially I didn’t think I could do it; I had so much anxiety. I depended on my mother a lot. Taking her out of the picture was a hard thing.”

But her advisors, including Hadyn Swecker, who “was a huge support,” made sure she stayed on track, she says. She also credits her grandfather, Coleman Powell, for giving her undying love and support. Today, she feels strengthened to carry on in honor of her parents.

“It is going to be fine,” Wilkins says of her future and Saturday’s graduation. “My parents would be very pleased. It is sad that they are not going to be there, but the rest of my family will be there” – biological and otherwise.

“I’ll be there,” Wade says of Saturday’s commencement, “and be very proud to see her walk across the stage.”

In the true holiday tradition of giving, UAB and the American Red Cross will host “Six Days of Giving,” a blood drive to be held at UAB Hospital Dec. 12-17, 2011. Holiday schedules can disrupt normal blood donation schedules and blood is often in short supply at the end of December.

The UAB/Red Cross drive will be on the second-floor atrium of the UAB North Pavilion, 18th Street and Sixth Ave. Hours are 10 a.m. to 5 p.m. Monday-Thursday, Dec. 12-15 and 7 a.m. to 2 p.m. Friday and Saturday, Dec. 16-17.

Donors will receive a $5 meal ticket at the UAB Hospital food court, and there will be daily prize giveaways. Donors will also be eligible for a grand prize of an iPad 2. Validated parking is available at the Fourth Avenue parking deck. Donors should bring a photo ID.

UAB is one of the largest users of blood nationally supplied by the Red Cross. Donors can give blood up to six times a year, every eight weeks. The overall process takes about 45 minutes; blood collection usually takes less than 20 minutes.

Blood products are used during surgery, transplantation, trauma care, difficult pregnancies and cancer treatment. It is not unheard of for a single patient to require as many as 100 units of blood.

A low-cost interventiongives even the earliest preemies a chance to survive and thrive.

With chubby cheeks and weighing in at a healthy 10 pounds, the imminently huggable Lexi Morrison is far removed from the 1-pound, 9 –ounce preemie she was in June when she was born premature at 24 weeks.

Giving antenatal corticosteroids in extremely preterm infants like Lexi — those born between 22 and 25 weeks gestation and weighing less than 2 pounds — is associated with significant reductions in death and long-term complications such as neurodevelopmental impairments, including cerebral palsy, poor motor skills and lower intelligence, according to research by Wally Carlo, M.D., director of the UAB Division of Neonatology, published in the Dec. 7, 2011, issue of the Journal of the American Medical Association.

Freeman knew she was at risk for premature labor; doctors placed a stitch in her cervix to keep it closed when she was 20 weeks pregnant, and she immediately went to the hospital when she began bleeding at 23 weeks. Several days later, at 24 weeks and two days, Lexi was born.

“I had problems before, and I lost a premature baby. I didn’t want it to happen again,” Freeman says. “They asked me if I wanted to use the steroids and I told them yes — whatever is better for Lexi I want to do it. They got two (doses) in me before she was born.”

Antenatal corticosteroids, when given to a woman in preterm labor, mature the lungs and other organs in the baby’s body. Two shots of the steroids have been recommended for women in premature labor as early as 24 weeks, but there were no data for 23 weeks or earlier gestation from randomized, controlled trials, Carlo says. And the data was quite limited in trials for pregnancies between 24 and 25 weeks.

“There also was very limited data on long-term outcomes for these babies; this is significant because it is important to increase survival and also to increase the quality of life,” he says. “We wanted to study the smallest premature babies because this is a very large population of infants, but the practice of giving antenatal corticosteroids to women at these gestational ages differs from physician to physician.”

Carlo also says there have been concerns about giving antenatal corticosteroids to some women in early premature labor, especially those susceptible to infection, because steroids lower the body’s ability to fight infection.

The study, funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and conducted by Carlo for the Neonatal Research Network, used data collected prospectively on babies born between January 1993 and January 2009 at 22 to 25 weeks gestation weighing between just under a pound to 2 pounds at 23 academic medical centers across the country. Carlo and his research team ultimately wanted to determine if antenatal corticosteroids worked as well in early premature babies, even in the long term, as they do in babies born at 26 weeks gestation and older.

“The results of the study showed that mortality was decreased by more than 33 percent and neurodevelopmental impairment was decreased by more than 20 percent,” Carlo says. “It seems that extremely premature infants, from 22 to 25 weeks, can respond as well as infants that are more mature. We also found that using the antenatal corticosteroids did not increase the infection rate for the mothers.”

Carlo says the study is important because it shows that a low-cost intervention, about $25 for two shots, gives even the earliest preemies a chance to survive and thrive.

“Delivery of a normal baby is an emotional occasion, and delivery of a premature baby is even more emotional. The ability to tell parents there is a treatment that has such major benefits is very comforting,” Carlo says. “They know there is something that can be done.”

Freeman is grateful for the opportunity at life antenatal corticosteroids gave her daughter.

“It was very easy, simple,” she says. “I’m very grateful. I thank God every day for it.”

UAB employees named "Hospital Heroes" by local chapter of the Alabama Hospital Association.

Three UAB hospital employees and one UAB physician were honored for their dedication to health care by the Birmingham Regional Hospital Council of the Alabama Hospital Association.

The association’s ninth annual “Hospital Heroes” award highlights health careers while recognizing the accomplishments and compassion of hospital employees. As many as 10 state hospital heroes will be honored at a banquet in February in Birmingham, along with one hospital physician hero.

UAB Health System honorees are:

Joyce Horn, patient advocate for UAB Callahan Eye Hospital, where she has worked since 1972. She was a medical technologist and lab manager before assuming the newly created role of patient advocate upon her retirement from the lab in 2009.

John McGowan, a certified optician and Optical Shoppe manager at the UAB Callahan Eye Hospital, where he has worked since 1993. He was instrumental in organizing a donation of more than 900 pairs of reading glasses to victims of the April 27 tornadoes and has helped facilitate ongoing support of victims.

Terry Sims, a patient care assistant for UAB Callahan Eye Hospital, where he began working as a housekeeper in 1987 and was later promoted to his current role.

UAB hospital physician honoree is:

Kellie L. Flood, M.D., an associate professor of medicine and medical director of the Acute Care for Elders Unit at UAB Hospital. Flood joined UAB in 2006 and founded the ACE Unit to improve outcomes for older adult patients by providing an interdisciplinary approach to geriatric care. She also directs UAB’s Geriatric Scholars program.

UAB patient Parker Crawford and his family want to raise awareness of craniofacial disorders.

Parker Crawford is like most kids his age — he likes to play video games and watch movies. But unlike his peers, he has more to worry about than the latest release.

Crawford misses school several times a month to travel from his home in Sylacauga, Ala., for appointments with various medical specialists at the University of Alabama at Birmingham. He was born at UAB Hospital in 1999 with an unspecified craniofacial disorder that kept him hospitalized for the first six months of his life.

“When I was little I didn’t have nose holes,” Crawford says, referring to his sinus passages. He’s now had more than 30 surgeries in his 12 years to reconstruct the bones in his face.

UAB is well known throughout the country and the world for its constellation of expert physicians and scientists, and Crawford has come to know several, from geneticists to oral-maxillofacial surgeons to world-class nursing care, who have become like family. But, the toughest part of his ordeal comes from trying to fit in with other kids, says his mom Lisa Crawford.

Earlier this year, she wrote on UAB’s Facebook, asking for help in raising awareness about kids like her son who live with craniofacial disorders. “Read (about a) little boy who struggles through life,” she wrote.

“Look inside their heart, not their face,” she said recently. She wants to start a support group in Alabama for families affected by craniofacial disorders. “Support helps spread awareness. Everybody should know more about these disorders and understand why those who have them look different,” she says.

Joshua Klapow, Ph.D., UAB clinical psychologist, says a social support network, which can include a local support group, is key to helping children with physical disorders cope with mistreatment.

“A child with a disfigurement has to endure stares, avoidance and awkward questions on a regular basis. Throw bullying on top of that and the pressure and psychological scarring can be almost unfathomable,” Klapow says.

“Strong relationships with the people around them who will stand-up for them, protect them and — most important — normalize their existence will aid them psychologically,” Klapow says.

Crawford’s geneticist, Nathaniel Robin, M.D., professor in the UAB Departments of Genetics and Pediatrics, agrees and says such a group could even help improve diagnoses.

“It allows families to discuss the challenges of having a child with this condition with others worldwide and find out how those cases are being treated,” Robin says.

Because Crawford’s condition isgenetic, his sister Mary, two years his senior, was tested leading to the discovery that she also had a craniofacial disorder.

Even Crawford’s surgery, while aimed at making him physically whole, also addresses his social needs.

Peter Waite, M.D., D.D.S., chair of the UAB Division of Oral and Maxillofacial Surgery, has performed several of Crawford’s surgeries since 2005. His goal, he says, is to completely reconstruct his face. “The objective is a functional outcome — the ability to breath, chew and speak and pronounce words — but one benefit will be cosmetic and enhance his psychosocial well-being,” Waite says.

Crawford, game player in hand, says despite the bullying he doesn’t feel different; people with craniofacial disorders are like everyone else.

A U.S. Air Force Special Operations surgical team now calls UAB home between deployments overseas, honing their medical skills at UAB’s Level 1 trauma center.

Early in the twilight dawn on Birmingham’s Ruffner Mountain, a line of seven men in fatigues snakes along a heavily wooded, steep trail. On their backs are tan rucksacks, 30 to 45 pounds each. There’s no talking, they have another mile to go. At their destination, deep in the woods, they open the packs and set up their gear – not tents and sleeping bags, but a mobile operating room.

They are members of a United States Air Force Special Ops Surgical Team-Special Ops Critical Care Evacuation Team (SOST-SOCCET in military shorthand) with the 1st Special Operations Support Squadron at Hurlburt Field in Florida, led by Lt. Col. Jon Winkler, M.D., a trauma surgeon and the team commander.

But rather than being stationed at a stateside Air Force base where most military hospitals are primary care facilities, this team is helping create a new definition of readiness – they’re also full-fledged members of the University of Alabama at Birmingham’s Level I trauma center, where more than 3,000 patients are seen each year with injuries – from car wrecks, accidents or crime – that mimic what the team would see in battle.

Winkler’s team is on Ruffner Mountain for a training exercise. One day a week, they shoulder their gear and hike on steep, rocky trails — the kind of terrain they might find in Afghanistan, Iraq or anywhere else the U.S. military might be deployed. They can set up an operating room nearly anywhere — farm house, shack, mountain top or valley floor.

“UAB sees a lot of trauma,” he notes. “I performed more trauma surgeries in just a few months here than I did during the previous year at Hurlburt Field. When we deploy next, our trauma skills and our team skills will be top notch.”

SOST-SOCCET comprises trauma and orthopedic surgeons, emergency physicians, a nurse anesthetist, surgical scrub tech, critical-care nurse and respiratory tech. They work together at UAB, in surgery, in the trauma center and in the intensive-care units.

They carry a combination litter/operating table. One rucksack has surgical gear; another has anesthesia equipment. They have trauma packs, critical-care nursing supplies and electronic monitors. Their job is to provide forward — far forward — care to injured members of U.S. Special Forces teams during missions in any of the world’s dangerous hot spots.

“We can be positioned with special operations forces, to provide damage-controlling, life-saving surgery,” said Winkler. “We can stabilize and then transport them to a higher level facility where they can receive care.”

Most military hospitals typically don’t see the volume or severity of cases that are seen at a major trauma center like UAB, the only one in the state and in a 150-mile radius. Conventional pre-deployment refresher courses have been less than satisfactory, Winkler says.

“Refresher courses, though held at top civilian hospitals, were for only a few weeks duration and mainly for observation,” said Winkler. “We had no real responsibility, no decision-making authority. It was more like being in medical school or the early stages of residency. We needed a better way to maintain our team’s skills at peak levels.”

The Air Force solution was to position a full team at a Level I trauma center for an extended tour of duty, up to three years, at UAB and also in St. Louis.

“Being in a Level I trauma center enables each specialty within the team to maintain a very high proficiency in their skill level,” said Winkler. “And we work together, so when we are deployed everyone knows the other team members well and we work smoothly together.”

The team has been at UAB since summer 2010, with one classified deployment in early 2011.

“UAB is a good training ground,” said Jeff Kerby, M.D., Ph.D., a UAB trauma surgeon. “We have a great many penetrating trauma cases here, so much of what we see in the civilian setting mimics what they will be seeing when they deploy.”

Kerby, a former Air Force trauma surgeon, is the link between UAB and SOST-SOCCET. He calls the arrangement a win-win for both UAB and the military.

“Most of the major, significant contributions in trauma surgery have been made during times of military conflict,” he said. “So I think this affiliation with the military and tapping into their experience, their expertise, certainly has a positive impact on what we’re trying to do here as a trauma center. At the same time, for them to work as a team, in a busy, high-volume trauma center, has a positive impact on what they are trying to accomplish.”

For Winkler and his team, it’s about being ready to do the job to the best of their ability when they are called upon.

“The goal, the underlying goal, is to make ourselves as proficient as we can be,” he said, “so that if our soldiers, sailors or airmen are injured, we stand ready to provide the best possible care.”